Jorgensen Schmidt, Diane

Jorgensen Schmidt, Diane is an individual health care provider with primary practice located at 106 S Perry St Ste 4, Watkins Glen NY 14891-1615. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Jorgensen Schmidt, Diane can be contacted via phone (607) 535-8282.

Contact Information

Primary practice address
106 S Perry St Ste 4 Watkins Glen NY 14891-1615
Phone: (607) 535-8282
Fax: (607) 535-8284
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 072659 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 072659 New York

Profile Details

NPI number 1245271956
LBN Legal business name Jorgensen Schmidt, Diane
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245271956 NPPES
New York MEDICAID 07300024693LI

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