Provider Demographics
NPI:1619404670
Name:SCHMITT, JENNIFER KRISTIN (LMHC, CASAC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:KRISTIN
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:LMHC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 IMPALA DR
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-1504
Mailing Address - Country:US
Mailing Address - Phone:631-335-0108
Mailing Address - Fax:
Practice Address - Street 1:107 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-2337
Practice Address - Country:US
Practice Address - Phone:631-335-0108
Practice Address - Fax:631-666-1709
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-21
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007847101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health