Provider Demographics
NPI:1407633753
Name:SCHMIDT, JANNA DIRE (LCAC)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:DIRE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 N LAST CHANCE GULCH
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-0700
Mailing Address - Country:US
Mailing Address - Phone:406-565-6641
Mailing Address - Fax:
Practice Address - Street 1:1824 N LAST CHANCE GULCH
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-0700
Practice Address - Country:US
Practice Address - Phone:406-594-6972
Practice Address - Fax:406-513-1055
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT64611101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)