Provider Demographics
NPI:1093058349
Name:SCHMITT, SUSAN (LPC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BEAVER CREEK RUN
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-2233
Mailing Address - Country:US
Mailing Address - Phone:770-301-4691
Mailing Address - Fax:
Practice Address - Street 1:85 BEAVER CREEK RUN
Practice Address - Street 2:
Practice Address - City:SHARPSBURG
Practice Address - State:GA
Practice Address - Zip Code:30277-2233
Practice Address - Country:US
Practice Address - Phone:770-301-4691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006972101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional