Healthcare Provider Details

I. General information

NPI: 1639987175
Provider Name (Legal Business Name): JAMIE LYNN SCHMIEDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3512 N HIGLEY RD
MESA AZ
85215-9713
US

IV. Provider business mailing address

1182 S PENROSE DR
GILBERT AZ
85296-8808
US

V. Phone/Fax

Practice location:
  • Phone: 602-449-7999
  • Fax:
Mailing address:
  • Phone: 520-975-4860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-16818
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: