MEDICARE: MRS. RACHEL JENKINS SCHWAGER MSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-28190	NC
2	1041C0700X	Clinical Social Worker	P017602	NC

General Provider Information

NPI Number	:	1407585318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL JENKINS SCHWAGER MSW

Provider Business Mailing Address
First Line	:	2344 WOODRIDGE DR
Second Line	:
City	:	WINTERVILLE
State	:	NC
Zip	:	28590-8557
Country	:	US
Telephone Number	:	252-413-8522
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 EVANS ST STE 301
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-1831
Country	:	US
Telephone Number	:	984-235-2545
Fax Number	:

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

Provider Enumeration Date	:	06/07/2022
Last Update Date	:	06/20/2022

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