Provider Demographics
NPI:1265150270
Name:SCHMIDT, LYNSE LINETE
Entity type:Individual
Prefix:MRS
First Name:LYNSE
Middle Name:LINETE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72442 US HIGHWAY 183
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-3435
Mailing Address - Country:US
Mailing Address - Phone:308-991-1867
Mailing Address - Fax:
Practice Address - Street 1:72442 US HIGHWAY 183
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-3435
Practice Address - Country:US
Practice Address - Phone:308-991-1867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3723621891103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool