Provider Demographics
NPI:1508197542
Name:SCHMIDT, BRANDON JAMES (LMFT)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:JAMES
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16204 KATIE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1493
Mailing Address - Country:US
Mailing Address - Phone:405-426-0998
Mailing Address - Fax:
Practice Address - Street 1:16204 KATIE RIDGE DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1493
Practice Address - Country:US
Practice Address - Phone:405-426-0998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200322630-BMedicaid