1801082284 NPI number — JASON R SCHMID LMHP, LPC

Table of content: JASON R SCHMID LMHP, LPC (NPI 1801082284)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801082284 NPI number — JASON R SCHMID LMHP, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMID
Provider First Name:
JASON
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHP, LPC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801082284
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3201 S 33RD ST
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68506-5755
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-435-4700
Provider Business Mailing Address Fax Number:
402-435-4701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3201 S 33RD ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68506-5755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-435-4700
Provider Business Practice Location Address Fax Number:
402-435-4701
Provider Enumeration Date:
09/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  1878 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 3776 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10025559500 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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