Provider Demographics
NPI:1346275807
Name:SCHMITZ, NANCY ANN (PHD /LPCC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ANN
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:PHD /LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1556 DON GASPAR AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4798
Mailing Address - Country:US
Mailing Address - Phone:505-820-1829
Mailing Address - Fax:505-992-1511
Practice Address - Street 1:1556 DON GASPAR AVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4798
Practice Address - Country:US
Practice Address - Phone:505-820-1829
Practice Address - Fax:505-992-1511
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3349101YM0800X
CAMFC 17082106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMZ23696Medicaid
NM109571OtherVALUE OPTIONS PROVIDER #