Healthcare Provider Details

I. General information

NPI: 1265971683
Provider Name (Legal Business Name): LAUREN MICHELLE SCHMITT PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 02/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE., ML 4002
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE., ML 4002
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-9645
  • Fax: 513-636-3800
Mailing address:
  • Phone: 513-636-9645
  • Fax: 513-636-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP.07753
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberP.07753
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2492
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: