Provider Demographics
NPI:1720579568
Name:SCHMIDT, CELESTE (LCMHCA, LCAS)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LCMHCA, LCAS
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:
Other - Last Name:HOCKENBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 TUCKASEEGEE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-2832
Mailing Address - Country:US
Mailing Address - Phone:704-523-5775
Mailing Address - Fax:
Practice Address - Street 1:4000 TUCKASEEGEE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-2832
Practice Address - Country:US
Practice Address - Phone:704-523-5775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14629101YP2500X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional