Provider Demographics
NPI:1538152384
Name:SCHMITZER, CARL L (MSW LCSW PIP)
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:L
Last Name:SCHMITZER
Suffix:
Gender:M
Credentials:MSW LCSW PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 S MINNESOTA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2707
Mailing Address - Country:US
Mailing Address - Phone:605-271-1348
Mailing Address - Fax:605-610-1477
Practice Address - Street 1:5000 S MINNESOTA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2707
Practice Address - Country:US
Practice Address - Phone:605-271-1348
Practice Address - Fax:605-610-1477
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD254104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
4511Medicare ID - Type Unspecified