Provider Demographics
NPI:1760089254
Name:SCHMIDT, JOHN KEVIN JR (LPCC, LCADC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:KEVIN
Last Name:SCHMIDT
Suffix:JR
Gender:M
Credentials:LPCC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SPRINGHILL DR
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2105
Mailing Address - Country:US
Mailing Address - Phone:502-910-1356
Mailing Address - Fax:
Practice Address - Street 1:125 SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2105
Practice Address - Country:US
Practice Address - Phone:502-910-1356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY296267101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health