Healthcare Provider Details

I. General information

NPI: 1033207386
Provider Name (Legal Business Name): CAROLINE G SCHMIDT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE G HENRY MS LPC

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 N PORT WASHINGTON RD SUITE 200
GLENDALE WI
53217-4929
US

IV. Provider business mailing address

5555 N PORT WASHINGTON RD SUITE 200
GLENDALE WI
53217-4929
US

V. Phone/Fax

Practice location:
  • Phone: 262-542-3255
  • Fax: 414-967-7965
Mailing address:
  • Phone: 262-542-3255
  • Fax: 414-967-7965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2866-057
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: