Provider Demographics
NPI:1164592176
Name:SCHMID, DONNA LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:SCHMID
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 1:2106 S RIDGEVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-8407
Mailing Address - Country:US
Mailing Address - Phone:208-308-1779
Mailing Address - Fax:
Practice Address - Street 1:2106 S RIDGEVIEW WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-8407
Practice Address - Country:US
Practice Address - Phone:208-308-1779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW245681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010141366OtherBLUESHIELD
IDL2250OtherBLUECROSS
ID806775900Medicaid