Healthcare Provider Details

I. General information

NPI: 1063329480
Provider Name (Legal Business Name): STEPHEN ANDREW SCHMIDT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 E TANQUE VERDE RD STE 210
TUCSON AZ
85715-3859
US

IV. Provider business mailing address

175 W VALENCIA RD APT 453
TUCSON AZ
85706-6303
US

V. Phone/Fax

Practice location:
  • Phone: 520-660-5683
  • Fax:
Mailing address:
  • Phone: 520-896-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-23853
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: