Basic Information
| Provider Information | |||||||||
| NPI: | 1215388343 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMIDT | ||||||||
| FirstName: | CANDACE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2325 INTELLIPLEX DR | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | SHELBYVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461768545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173922971 | ||||||||
| FaxNumber: | 3173981894 | ||||||||
| Practice Location | |||||||||
| Address1: | 2325 INTELLIPLEX DR | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | SHELBYVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461768545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173922971 | ||||||||
| FaxNumber: | 3173981894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2016 | ||||||||
| LastUpdateDate: | 06/30/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 20042963A | IN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TF0200X | 20042963A | IN | N | Behavioral Health & Social Service Providers | Psychologist | Forensic |
No ID Information.