Provider Demographics
NPI:1346539756
Name:SCHMIDT, SANDRA R (LPC-I)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:R
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 SEA HAWK LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-9038
Mailing Address - Country:US
Mailing Address - Phone:803-399-9240
Mailing Address - Fax:803-359-2111
Practice Address - Street 1:301A PALMETTO PARK BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7872
Practice Address - Country:US
Practice Address - Phone:803-399-9240
Practice Address - Fax:803-359-2111
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5419101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional