MEDICARE: VIRGINIA SCHWINDT

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
1	1041C0700X	Clinical Social Worker	4594	TN

General Provider Information

NPI Number	:	1255057337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA SCHWINDT

Provider Business Mailing Address
First Line	:	1636 E MAIN ST
Second Line	:
City	:	HUMBOLDT
State	:	TN
Zip	:	38343-2904
Country	:	US
Telephone Number	:	731-784-7833
Fax Number	:	731-784-7856

Provider Business Practice Location Address
First Line	:	1636 E MAIN ST
Second Line	:
City	:	HUMBOLDT
State	:	TN
Zip	:	38343-2904
Country	:	US
Telephone Number	:	731-784-7833
Fax Number	:	731-784-7856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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