Provider Demographics
NPI:1871791715
Name:SCHMIDT, LEORA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:LEORA
Middle Name:ANN
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEORA
Other - Middle Name:ANN
Other - Last Name:DICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:12 STATE HIGHWAY NO. 17 NORTH
Mailing Address - Street 2:SUITE 313
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-368-3700
Mailing Address - Fax:201-368-0055
Practice Address - Street 1:12 STATE HIGHWAY NO. 17 NORTH
Practice Address - Street 2:SUITE 313
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-368-3700
Practice Address - Fax:201-368-0055
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP015154-11041C0700X
NJ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical