Healthcare Provider Details

I. General information

NPI: 1285805226
Provider Name (Legal Business Name): DONALD P SCHMIDT LCMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 COUNTRY CLUB RD
WINSTON SALEM NC
27104-2429
US

IV. Provider business mailing address

5101 COUNTRY CLUB RD
WINSTON SALEM NC
27104-2429
US

V. Phone/Fax

Practice location:
  • Phone: 336-714-5465
  • Fax:
Mailing address:
  • Phone: 336-714-5465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4151
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: