Provider Demographics
NPI:1417943648
Name:SCHMIDT, SUSAN E (PHD, APA-CPP SUBST)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:E
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHD, APA-CPP SUBST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 HAYMARKET LN
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1148
Mailing Address - Country:US
Mailing Address - Phone:610-527-2278
Mailing Address - Fax:
Practice Address - Street 1:54 HAYMARKET LN
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1148
Practice Address - Country:US
Practice Address - Phone:610-527-2278
Practice Address - Fax:610-527-2278
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006839L103TA0400X, 103TC1900X
DEB1-0000464103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent