Provider Demographics
NPI:1942346499
Name:SCHMIDT, CASEY W (PHD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:W
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325C THOMASVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7905
Mailing Address - Country:US
Mailing Address - Phone:850-385-8222
Mailing Address - Fax:850-386-5476
Practice Address - Street 1:3325C THOMASVILLE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7905
Practice Address - Country:US
Practice Address - Phone:850-385-8222
Practice Address - Fax:850-386-5476
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0005082103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical