Healthcare Provider Details

I. General information

NPI: 1558279992
Provider Name (Legal Business Name): NICKOLAUS SCHWARZ ED.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S 132ND ST
CHANDLER AZ
85225-6027
US

IV. Provider business mailing address

625 W 13TH ST
TEMPE AZ
85281-6362
US

V. Phone/Fax

Practice location:
  • Phone: 480-812-6877
  • Fax:
Mailing address:
  • Phone: 503-707-9045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number6157674
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: