Provider Demographics
NPI:1376564575
Name:SCHMITZ, CHARLENE KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:KAY
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3089
Mailing Address - Street 2:CENTER FOR MENTAL HEALTH
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-265-9639
Mailing Address - Fax:406-265-6771
Practice Address - Street 1:312 3RD ST
Practice Address - Street 2:CENTER FOR MENTAL HEALTH
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3534
Practice Address - Country:US
Practice Address - Phone:406-265-9639
Practice Address - Fax:406-265-6771
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT590 LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTP00692066 C01340OtherRAILROAD MEDICARE
MT0000071493OtherBLUE CROSS/SHIELD OF MONT
MTP00692066 C01340OtherRAILROAD MEDICARE