MEDICARE: JUSTINE RACHEL SCHMITT LCPC

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1720573751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTINE RACHEL SCHMITT LCPC

Provider Business Mailing Address
First Line	:	319 E 7TH ST
Second Line	:
City	:	CENTRALIA
State	:	IL
Zip	:	62801-4505
Country	:	US
Telephone Number	:	618-918-2115
Fax Number	:	618-918-2095

Provider Business Practice Location Address
First Line	:	319 E 7TH ST
Second Line	:
City	:	CENTRALIA
State	:	IL
Zip	:	62801-4505
Country	:	US
Telephone Number	:	618-918-2115
Fax Number	:	618-918-2095

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

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	03/19/2026

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