Provider Demographics
NPI:1487862975
Name:SCHMIDTGALL, KIRBY C (LPCC)
Entity type:Individual
Prefix:DR
First Name:KIRBY
Middle Name:C
Last Name:SCHMIDTGALL
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4246
Mailing Address - Country:US
Mailing Address - Phone:701-425-7298
Mailing Address - Fax:
Practice Address - Street 1:1009 N 14TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4246
Practice Address - Country:US
Practice Address - Phone:701-425-7298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND563-11-1-06-169101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional