Provider Demographics
NPI:1043408412
Name:SCHMIDT GEORGE, TERRI B (LCSW)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:B
Last Name:SCHMIDT GEORGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08862
Mailing Address - Country:US
Mailing Address - Phone:800-863-5385
Mailing Address - Fax:732-826-3627
Practice Address - Street 1:288 RUES LANE
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-257-6100
Practice Address - Fax:732-651-9834
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05180900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker