Provider Demographics
NPI:1699199828
Name:SCHMIDT IKONOMOPOULOS, CLAUDIA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:SCHMIDT IKONOMOPOULOS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61226
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-1226
Mailing Address - Country:US
Mailing Address - Phone:361-442-4024
Mailing Address - Fax:361-853-7877
Practice Address - Street 1:6000 S STAPLES ST STE 406
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2952
Practice Address - Country:US
Practice Address - Phone:361-739-1679
Practice Address - Fax:361-652-5524
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX328976102Medicaid
TX328976103Medicaid
TX328976107Medicaid