Provider Demographics
NPI:1598333171
Name:SCHMITHORST, VICTOR MARTIN
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:MARTIN
Last Name:SCHMITHORST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 ALBERT SABIN WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2838
Mailing Address - Country:US
Mailing Address - Phone:513-558-9006
Mailing Address - Fax:
Practice Address - Street 1:311 ALBERT SABIN WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2838
Practice Address - Country:US
Practice Address - Phone:513-558-9006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist