Provider Demographics
NPI:1396367421
Name:SCHMITZ, KATHRYN ANN (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ODYSSEY DR
Mailing Address - Street 2:
Mailing Address - City:BOSWELL
Mailing Address - State:PA
Mailing Address - Zip Code:15531-1834
Mailing Address - Country:US
Mailing Address - Phone:360-451-9591
Mailing Address - Fax:
Practice Address - Street 1:140 ODYSSEY DR
Practice Address - Street 2:
Practice Address - City:BOSWELL
Practice Address - State:PA
Practice Address - Zip Code:15531-1834
Practice Address - Country:US
Practice Address - Phone:360-451-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012378101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional