Provider Demographics
NPI:1194465013
Name:SCHMIDT, CHERYL (LCADC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 RINGWOOD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07420-1451
Mailing Address - Country:US
Mailing Address - Phone:973-628-8530
Mailing Address - Fax:973-628-6856
Practice Address - Street 1:1069 RINGWOOD AVE STE 202
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:NJ
Practice Address - Zip Code:07420-1451
Practice Address - Country:US
Practice Address - Phone:973-628-8530
Practice Address - Fax:973-628-6856
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00205200101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)