Provider Demographics
NPI:1376148452
Name:SCHMIDT, KASSIDY JANE (MA, NCC)
Entity Type:Individual
Prefix:MS
First Name:KASSIDY
Middle Name:JANE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 WILSON BLVD STE 410
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-3324
Mailing Address - Country:US
Mailing Address - Phone:703-875-0475
Mailing Address - Fax:
Practice Address - Street 1:2200 WILSON BLVD STE 410
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3324
Practice Address - Country:US
Practice Address - Phone:703-875-0475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional