Healthcare Provider Details

I. General information

NPI: 1528469657
Provider Name (Legal Business Name): DEREK ROYCE SCHWEITZER LCSW, LIMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5308 PARKLANE DR STE 5
KEARNEY NE
68847-8629
US

IV. Provider business mailing address

3720 A AVE SUITE E
KEARNEY NE
68847-8169
US

V. Phone/Fax

Practice location:
  • Phone: 308-251-2222
  • Fax: 308-251-2232
Mailing address:
  • Phone: 308-234-5644
  • Fax: 308-234-5652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10345
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6944
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: