Provider Demographics
NPI:1336689652
Name:CASEY W. SCHMIDT, PHD
Entity Type:Organization
Organization Name:CASEY W. SCHMIDT, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASET
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:850-385-8222
Mailing Address - Street 1:3325 THOMASVILLE RD STE C
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7970
Mailing Address - Country:US
Mailing Address - Phone:850-385-8222
Mailing Address - Fax:850-386-5476
Practice Address - Street 1:3325 THOMASVILLE RD STE C
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7970
Practice Address - Country:US
Practice Address - Phone:850-385-8222
Practice Address - Fax:850-386-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty