Provider Demographics
NPI:1497441349
Name:SCHMIDT, ERIKA JEWELL
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:JEWELL
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13015 W RANCHO SANTE FE BLVD
Mailing Address - Street 2:APT 1137
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392
Mailing Address - Country:US
Mailing Address - Phone:623-824-2121
Mailing Address - Fax:
Practice Address - Street 1:10320 W MCDOWELL RD STE 7022
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4871
Practice Address - Country:US
Practice Address - Phone:623-215-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health