Provider Demographics
NPI:1679689111
Name:SCHMIDT-DONALDSON, TAMMY J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:J
Last Name:SCHMIDT-DONALDSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E WASHINGTON ST
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-2585
Mailing Address - Country:US
Mailing Address - Phone:262-335-4545
Mailing Address - Fax:262-335-6827
Practice Address - Street 1:333 E WASHINGTON ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-2585
Practice Address - Country:US
Practice Address - Phone:262-335-4545
Practice Address - Fax:262-335-6827
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7164-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43593100Medicaid