Provider Demographics
NPI:1265650899
Name:SCHMIDT, LEON RICHARD (SOCIAL WORKER)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:RICHARD
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 HENRY CT NW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52405-2953
Mailing Address - Country:US
Mailing Address - Phone:319-396-9477
Mailing Address - Fax:319-396-9477
Practice Address - Street 1:222 3RD AVE SE
Practice Address - Street 2:SUITE 299
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-1542
Practice Address - Country:US
Practice Address - Phone:319-396-9477
Practice Address - Fax:319-396-9477
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical