Provider Demographics
NPI:1689650301
Name:SCHMIDT, JAMIE SUE (M ED LMFT LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:SUE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:M ED LMFT LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 VALENCIA DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7356
Mailing Address - Country:US
Mailing Address - Phone:910-346-9000
Mailing Address - Fax:910-355-0672
Practice Address - Street 1:200 VALENCIA DR
Practice Address - Street 2:SUITE 107
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7356
Practice Address - Country:US
Practice Address - Phone:910-346-9000
Practice Address - Fax:910-355-0672
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC561101YP2500X
NC721106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC74846OtherBCBS