Provider Demographics
NPI:1912022955
Name:SCHMIDT, SHIRLEY JEAN (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:JEAN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 MONDEAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2533
Mailing Address - Country:US
Mailing Address - Phone:210-561-9200
Mailing Address - Fax:210-561-9200
Practice Address - Street 1:8535 WURZBACH RD STE 215
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1263
Practice Address - Country:US
Practice Address - Phone:210-561-9200
Practice Address - Fax:210-561-9200
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13655101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health