Provider Demographics
NPI:1578298253
Name:SCHMIDT, TAYLOR NICOLE WOON HEE (MSW, LGSW, LADC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NICOLE WOON HEE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MSW, LGSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 WATERSTONE PL APT 218
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55305-7504
Mailing Address - Country:US
Mailing Address - Phone:612-236-8155
Mailing Address - Fax:
Practice Address - Street 1:1246 UNIVERSITY AVE W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4125
Practice Address - Country:US
Practice Address - Phone:651-204-7009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29530104100000X
MN305913101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker