Healthcare Provider Details

I. General information

NPI: 1154267144
Provider Name (Legal Business Name): KALIE MARIE SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 E MAIN ST STE 107B
PLAINFIELD IN
46168-2816
US

IV. Provider business mailing address

9688 TRAIL DR
AVON IN
46123-9133
US

V. Phone/Fax

Practice location:
  • Phone: 317-286-6701
  • Fax:
Mailing address:
  • Phone: 317-286-6701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88001688A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: