Provider Demographics
NPI:1174858617
Name:SCHMIDT, TRACY A (LPCC, LADC)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:A
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LPCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8646 EAGLE CREEK CIRCLE
Mailing Address - Street 2:SUITE #213
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-1574
Mailing Address - Country:US
Mailing Address - Phone:952-210-1779
Mailing Address - Fax:612-437-4463
Practice Address - Street 1:8646 EAGLE CREEK CIR STE 213
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-1574
Practice Address - Country:US
Practice Address - Phone:952-210-1779
Practice Address - Fax:612-437-4463
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN300169101YA0400X
MNCC00151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)