Provider Demographics
NPI:1700034329
Name:SCHMIDT, JENNIFER MAXWELL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MAXWELL
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 PEACHTREE PKWY
Mailing Address - Street 2:SUITE E-149
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6034
Mailing Address - Country:US
Mailing Address - Phone:678-414-6821
Mailing Address - Fax:
Practice Address - Street 1:6740 JAMESTOWN DRIVE
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3948
Practice Address - Country:US
Practice Address - Phone:678-414-6821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003206103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist