Healthcare Provider Details

I. General information

NPI: 1023309895
Provider Name (Legal Business Name): JANE VICTORIA SCHWARK MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2011
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HIGHWAY 55
HASTINGS MN
55033-2368
US

IV. Provider business mailing address

1600 HIGHWAY 55
HASTINGS MN
55033-2368
US

V. Phone/Fax

Practice location:
  • Phone: 651-438-8219
  • Fax: 651-438-8252
Mailing address:
  • Phone: 651-438-8219
  • Fax: 651-438-8252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18963
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: