Provider Demographics
NPI:1689103376
Name:SCHMIDT, MEGAN RYAN (PHD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:RYAN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2964 PEACHTREE RD NW STE 324
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2120
Mailing Address - Country:US
Mailing Address - Phone:706-474-8226
Mailing Address - Fax:770-953-4640
Practice Address - Street 1:2964 PEACHTREE RD NW STE 324
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2120
Practice Address - Country:US
Practice Address - Phone:706-474-8226
Practice Address - Fax:770-953-4640
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004521103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical