Provider Demographics
NPI:1487708657
Name:SCHMIDT, DEBORAH (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:SCHMIDT-POTTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:23441 S POINTE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1550
Mailing Address - Country:US
Mailing Address - Phone:949-829-9447
Mailing Address - Fax:
Practice Address - Street 1:23441 S POINTE DR STE 140
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1550
Practice Address - Country:US
Practice Address - Phone:949-829-9447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS92401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACSW092400OtherMEDICAL
CACSW092400Medicaid
CASW9240Medicare PIN