Basic Information
Provider Information
NPI: 1477826667
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMITT
FirstName: COLLEEN
MiddleName: FRANCES
NamePrefix:  
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 812 E JOLLY RD STE 210
Address2:  
City: LANSING
State: MI
PostalCode: 489106825
CountryCode: US
TelephoneNumber: 5173468275
FaxNumber: 5173468291
Practice Location
Address1: 812 E JOLLY RD STE 311
Address2:  
City: LANSING
State: MI
PostalCode: 489106821
CountryCode: US
TelephoneNumber: 5173468318
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/17/2012
LastUpdateDate: 03/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XL4530ORN Behavioral Health & Social Service ProvidersSocial WorkerClinical
1041C0700X6801066492MIY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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