Provider Demographics
NPI:1487779179
Name:SCHMIDT, GARY CHARLES (LMHC, LIMHP)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:CHARLES
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:LMHC, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N SHANNON DR
Mailing Address - Street 2:
Mailing Address - City:SLOAN
Mailing Address - State:IA
Mailing Address - Zip Code:51055-7756
Mailing Address - Country:US
Mailing Address - Phone:712-899-1307
Mailing Address - Fax:
Practice Address - Street 1:809 N SHANNON DR
Practice Address - Street 2:
Practice Address - City:SLOAN
Practice Address - State:IA
Practice Address - Zip Code:51055-7756
Practice Address - Country:US
Practice Address - Phone:712-899-1307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00402101YM0800X
NE185101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health