Provider Demographics
NPI:1093973620
Name:SCHMIDT, CAROLINE JOAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:JOAN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:JOAN
Other - Last Name:KENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:800 HOWARD AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1369
Mailing Address - Country:US
Mailing Address - Phone:203-737-7093
Mailing Address - Fax:
Practice Address - Street 1:800 HOWARD AVE FL 1
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1369
Practice Address - Country:US
Practice Address - Phone:203-785-7411
Practice Address - Fax:203-785-4194
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017913-1103TC0700X
CT003561103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty