Provider Demographics
NPI:1134987415
Name:EPPLY-SCHMIDT, ALEXANDER (LSW)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:EPPLY-SCHMIDT
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 NELSON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7436
Mailing Address - Country:US
Mailing Address - Phone:609-647-8071
Mailing Address - Fax:
Practice Address - Street 1:2 TREE FARM RD STE A220
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-1487
Practice Address - Country:US
Practice Address - Phone:609-613-0110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06837800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker