Healthcare Provider Details

I. General information

NPI: 1285920397
Provider Name (Legal Business Name): MEGAN SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 12/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 W SOUTH BLVD STE 200
TROY MI
48085-1612
US

IV. Provider business mailing address

1439 E CAMBOURNE ST
FERNDALE MI
48220-1531
US

V. Phone/Fax

Practice location:
  • Phone: 248-330-2545
  • Fax:
Mailing address:
  • Phone: 248-330-2545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: