Provider Demographics
NPI:1710219027
Name:SCHMIDT, DIANE K (LMSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:K
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8575 W 110TH ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1868
Mailing Address - Country:US
Mailing Address - Phone:913-345-9333
Mailing Address - Fax:913-345-9335
Practice Address - Street 1:8575 W 110TH ST
Practice Address - Street 2:SUITE 304
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1868
Practice Address - Country:US
Practice Address - Phone:913-345-9333
Practice Address - Fax:913-345-9335
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6473104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS42628018OtherBLUE CROSS AND BLUE SHIELD