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NPI Code Detail

MEDICARE: MS. TRACY A SCHMIDT LPCC, LADC

MEDICARE: MS. TRACY A SCHMIDT LPCC, LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor300169MN
2101YM0800XMental Health CounselorCC00151MN

General Provider Information

NPI Number : 1174858617
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRACY A SCHMIDT LPCC, LADC
Provider Business Mailing Address
First Line : 8646 EAGLE CREEK CIRCLE
Second Line : SUITE #213
City : SAVAGE
State : MN
Zip : 55378-1574
Country : US
Telephone Number : 952-210-1779
Fax Number : 612-437-4463
Provider Business Practice Location Address
First Line : 8646 EAGLE CREEK CIR STE 213
Second Line :
City : SAVAGE
State : MN
Zip : 55378-1574
Country : US
Telephone Number : 952-210-1779
Fax Number : 612-437-4463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2009
Last Update Date : 07/30/2023

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