MEDICARE: KAREN SCHMIDT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1619345048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN SCHMIDT

Provider Business Mailing Address
First Line	:	6645 PEACHTREE DUNWOODY RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-1606
Country	:	US
Telephone Number	:	770-455-7111
Fax Number	:	770-274-3460

Provider Business Practice Location Address
First Line	:	6645 PEACHTREE DUNWOODY RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-1606
Country	:	US
Telephone Number	:	770-455-7111
Fax Number	:	770-274-3460

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2015
Last Update Date	:	09/02/2015

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