Provider Demographics
NPI:1487709325
Name:SCHMOKER, H MICHAEL SR (LCSW)
Entity type:Individual
Prefix:MR
First Name:H
Middle Name:MICHAEL
Last Name:SCHMOKER
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73525
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707-3525
Mailing Address - Country:US
Mailing Address - Phone:907-452-4405
Mailing Address - Fax:
Practice Address - Street 1:250 CUSHMAN STREET
Practice Address - Street 2:STE 4F
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4665
Practice Address - Country:US
Practice Address - Phone:907-452-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKR77482Medicare UPIN