Provider Demographics
NPI:1336321975
Name:SCHMIDT, STACEY (LICSW)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:LITZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW # 2A38
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-2848
Mailing Address - Fax:202-877-6292
Practice Address - Street 1:110 IRVING ST NW # 2A38
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-2848
Practice Address - Fax:202-877-6292
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500784201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical