Provider Demographics
NPI:1093053506
Name:SCHMALZRIED, RICHARD WILLIAM (LMFT (CA), LLP (MI))
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:WILLIAM
Last Name:SCHMALZRIED
Suffix:
Gender:M
Credentials:LMFT (CA), LLP (MI)
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 773
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-0773
Mailing Address - Country:US
Mailing Address - Phone:424-257-8057
Mailing Address - Fax:
Practice Address - Street 1:1711 VIA EL PRADO STE 202
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5721
Practice Address - Country:US
Practice Address - Phone:424-257-8057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT103991106H00000X
MI6301014421103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist