Individual provider Active NPI

Robert W Schmidt, LPC

  • Professional Counselor
  • Sandy Hook, CT
National Provider Identifier
1457692063
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
000955 Issued in CT
Practice address
11 Serenity LN
Sandy Hook, CT 06482-1630
Phone
(203) 788-2821
NPI assigned
Mar 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 000955 CT Primary

Addresses

Primary practice location

11 Serenity LN
Sandy Hook, CT 06482-1630

Mailing address

11 Serenity LN
Sandy Hook, CT 06482-1630
Phone (203) 788-2821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212002914 CT Practitioner - Mental Health Counselor 0143663690 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000955CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Presentations LLC Professional CurrentSince Jan 9, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1457692063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SERENITY LN",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821630",
            "telephone_number": "203-788-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SERENITY LN",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821630",
            "telephone_number": "203-788-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "000955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Hook, CT

Sources for this page

Verify at the official NPI Registry.