Provider Demographics
NPI:1740588052
Name:SCHMIDTMCCLINTOCK, DENISE DIANE (MSW LLSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:DIANE
Last Name:SCHMIDTMCCLINTOCK
Suffix:
Gender:F
Credentials:MSW LLSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9067 US HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1664
Mailing Address - Country:US
Mailing Address - Phone:269-815-5331
Mailing Address - Fax:269-815-5061
Practice Address - Street 1:9067 US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1664
Practice Address - Country:US
Practice Address - Phone:269-815-5331
Practice Address - Fax:269-815-5061
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010901731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical