MEDICARE: MRS. TAMMY J SCHMIDT-DONALDSON LCSW

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	1041C0700X	Clinical Social Worker	7164-123	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679689111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMMY J SCHMIDT-DONALDSON LCSW

Provider Business Mailing Address
First Line	:	333 E WASHINGTON ST
Second Line	:	SUITE 2000
City	:	WEST BEND
State	:	WI
Zip	:	53095-2585
Country	:	US
Telephone Number	:	262-335-4545
Fax Number	:	262-335-6827

Provider Business Practice Location Address
First Line	:	333 E WASHINGTON ST
Second Line	:	SUITE 2000
City	:	WEST BEND
State	:	WI
Zip	:	53095-2585
Country	:	US
Telephone Number	:	262-335-4545
Fax Number	:	262-335-6827

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/08/2007

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