Provider Demographics
NPI:1629250006
Name:KLEINSCHMIDT, ERICH (MSW)
Entity Type:Individual
Prefix:MR
First Name:ERICH
Middle Name:
Last Name:KLEINSCHMIDT
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 PORTER ST
Mailing Address - Street 2:BARQUIST US ARMY HEALTH CLINIC
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9211
Mailing Address - Country:US
Mailing Address - Phone:301-619-7175
Mailing Address - Fax:
Practice Address - Street 1:1425 PORTER ST
Practice Address - Street 2:BARQUIST US ARMY HEALTH CLINIC
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9211
Practice Address - Country:US
Practice Address - Phone:301-619-7175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10314931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDVAD000Medicare UPIN