Healthcare Provider Details

I. General information

NPI: 1952656324
Provider Name (Legal Business Name): MICHELLE LEE SCHMIDT MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 N BROAD ST, SUITE 301
WOODBURY NJ
08096
US

IV. Provider business mailing address

3 TWO PENNY RUN E
PILESGROVE NJ
08098-2641
US

V. Phone/Fax

Practice location:
  • Phone: 856-251-0500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00436700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: