Healthcare Provider Details

I. General information

NPI: 1578536280
Provider Name (Legal Business Name): JUDITH ANN SCHWARTZ LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2006
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 WALDEN ST
CONCORD MA
01742-2533
US

IV. Provider business mailing address

472 BEDFORD ST
CONCORD MA
01742-1855
US

V. Phone/Fax

Practice location:
  • Phone: 978-692-5070
  • Fax:
Mailing address:
  • Phone: 978-692-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1015707
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: