Healthcare Provider Details

I. General information

NPI: 1134581945
Provider Name (Legal Business Name): ZOEY SCHMIDT LCSW, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 W SCHROEDER DR
BROWN DEER WI
53223-1475
US

IV. Provider business mailing address

740 S 103RD ST
WEST ALLIS WI
53214-2526
US

V. Phone/Fax

Practice location:
  • Phone: 414-865-2471
  • Fax:
Mailing address:
  • Phone: 414-801-7413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17664-130
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9394-123
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: