Provider Demographics
NPI:1649808759
Name:DAWN SCHMELTZ LCSW LCAC LLC
Entity type:Organization
Organization Name:DAWN SCHMELTZ LCSW LCAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAC
Authorized Official - Phone:574-243-9370
Mailing Address - Street 1:2410 GRAPE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3015
Mailing Address - Country:US
Mailing Address - Phone:574-243-9370
Mailing Address - Fax:574-243-9375
Practice Address - Street 1:2410 GRAPE RD STE 1
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3015
Practice Address - Country:US
Practice Address - Phone:574-243-9370
Practice Address - Fax:574-243-9375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty