Healthcare Provider Details

I. General information

NPI: 1386632131
Provider Name (Legal Business Name): RUTH SCHWARTZ LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 DEVONSHIRE RD
TEWKSBURY MA
01876-3541
US

IV. Provider business mailing address

PO BOX 1163
STRATHAM NH
03885-1163
US

V. Phone/Fax

Practice location:
  • Phone: 978-851-4025
  • Fax: 978-851-3494
Mailing address:
  • Phone: 603-580-9445
  • Fax: 844-252-2008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1017148
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: