Basic Information
| Provider Information | |||||||||
| NPI: | 1588931281 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHMUTTER | ||||||||
| FirstName: | MINDY | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13325 GUY R BREWER BLVD | ||||||||
| Address2: | KIDWISE-SAFE SPACE AT MS 72 | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114342941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182762508 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13325 GUY R BREWER BLVD | ||||||||
| Address2: | KIDWISE-SAFE SPACE AT MS 72 | ||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114342941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182762508 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2011 | ||||||||
| LastUpdateDate: | 11/23/2011 | ||||||||
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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 | 1041C0700X | 081374 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.