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General NPI Number Information
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NPI Number | 1427573625
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Entity Type | Individual
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Provider Name | CRISSY SUE SCHMIEDER LCSW A, LCAS
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Gender | Female
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 08/08/2017
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Provider Practice Location Address
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Address Line | 225 S MADISON BLVD STE F
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City | ROXBORO
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State | NC
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Zip | 27573-5463
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Country | US
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Telephone | 336-322-3739
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Fax |
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Provider Business Mailing Address
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Address Line | 800 YORKSHIRE DR
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City | CLAYTON
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State | NC
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Zip | 27520-2955
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P0009882
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS3139
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License Number State | NC
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