Individual ProviderNicholas SchmidtPsychologistBehavioral Health & Social Service ProvidersPractice Address1500 E Woodrow Wilson Ave, Mental Health (11m), Jackson, MS 39216-5116(601) 362-4471PECOS EnrollmentBased on the most recent information from CMS, provider Nicholas Schmidt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1275912982Provider TypeIndividualFull NameSchmidt, NicholasTitleDr.CredentialPH.D.GenderMaleSole ProprietorYesEnumeration Date5/27/2015Last Updated5/27/2015Contact InformationPractice LocationPractice Address1500 E Woodrow Wilson Ave, Mental Health (11m), Jackson, MS 39216-5116Phone(601) 362-4471FaxUnlisted FaxMailing LocationMailing Address1500 E Woodrow Wilson Ave, Mental Health (11m), Jackson, MS 39216-5116Phone(601) 362-4471FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode103TC0700XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicense1956Alabama