Provider Demographics
NPI:1790542991
Name:SCHMITT, GRADY (PLMHP)
Entity Type:Individual
Prefix:
First Name:GRADY
Middle Name:
Last Name:SCHMITT
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11635 ARBOR ST STE 203
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5000
Mailing Address - Country:US
Mailing Address - Phone:402-315-8453
Mailing Address - Fax:402-513-7866
Practice Address - Street 1:11635 ARBOR ST STE 203
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5000
Practice Address - Country:US
Practice Address - Phone:402-315-8453
Practice Address - Fax:402-513-7866
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health