Provider Demographics
NPI:1194363127
Name:SCHMIDT, JENNIFER BERNIECE (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BERNIECE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:BERNIECE
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15858 W 158TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-6786
Mailing Address - Country:US
Mailing Address - Phone:913-593-6710
Mailing Address - Fax:
Practice Address - Street 1:9401 INDIAN CREEK PKWY STE 520
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2013
Practice Address - Country:US
Practice Address - Phone:913-380-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000150520101YP2500X
KS078101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional