Provider Demographics
NPI:1679037030
Name:SCHMIDTKE, CAMI MARIE (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CAMI
Middle Name:MARIE
Last Name:SCHMIDTKE
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:CAMI
Other - Middle Name:MARIE
Other - Last Name:PEARCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5729 HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-8125
Mailing Address - Country:US
Mailing Address - Phone:586-914-6092
Mailing Address - Fax:
Practice Address - Street 1:184 WILLIAMSBURG ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5720
Practice Address - Country:US
Practice Address - Phone:337-377-6206
Practice Address - Fax:866-399-7694
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-19-35807103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst