MEDICARE: JEAN-MARIE SCHWEIZER LPC, NCC, MDIV

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	101YM0800X	Mental Health Counselor	81452	TX

General Provider Information

NPI Number	:	1528744778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN-MARIE SCHWEIZER LPC, NCC, MDIV

Provider Business Mailing Address
First Line	:	5051 TRAIL LAKE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-2045
Country	:	US
Telephone Number	:	817-423-2970
Fax Number	:

Provider Business Practice Location Address
First Line	:	5051 TRAIL LAKE DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-2045
Country	:	US
Telephone Number	:	817-423-2970
Fax Number	:

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

Provider Enumeration Date	:	06/23/2023
Last Update Date	:	06/30/2023

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