Provider Demographics
NPI:1245808161
Name:SCHMIDT, ELLYN MCALLISTER (PHD)
Entity type:Individual
Prefix:DR
First Name:ELLYN
Middle Name:MCALLISTER
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 UNION ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4784
Mailing Address - Country:US
Mailing Address - Phone:617-800-9610
Mailing Address - Fax:866-496-3029
Practice Address - Street 1:6 UNION ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4784
Practice Address - Country:US
Practice Address - Phone:413-320-3875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2025-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11526103TC2200X
103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool