Healthcare Provider Details

I. General information

NPI: 1841343084
Provider Name (Legal Business Name): KRISTIN ELIZABETH SCHMIDT M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 LONG POND DR
SOUTH YARMOUTH MA
02664
US

IV. Provider business mailing address

5 CAPTAIN JUD ROAD
SOUTH DENNIS MA
02660
US

V. Phone/Fax

Practice location:
  • Phone: 508-398-5277
  • Fax:
Mailing address:
  • Phone: 774-212-0879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: