Provider Demographics
NPI:1396296570
Name:SCHMIDT, KATIE (MA, LPC, CSW)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:MA, LPC, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 SODA CREEK RD APT 6
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-1120
Mailing Address - Country:US
Mailing Address - Phone:303-915-2680
Mailing Address - Fax:
Practice Address - Street 1:626 E LONGVIEW DR LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-2130
Practice Address - Country:US
Practice Address - Phone:920-215-2260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-21
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12892-120104100000X
WI10912-125101YP2500X
WI7117-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker