Healthcare Provider Details

I. General information

NPI: 1114021672
Provider Name (Legal Business Name): MICHAEL BARNETT SCHWARTZ LCSW-R
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1342 56TH ST
BROOKLYN NY
11219-4616
US

IV. Provider business mailing address

14 SYLVIA LN
PLAINVIEW NY
11803-4802
US

V. Phone/Fax

Practice location:
  • Phone: 718-851-7100
  • Fax:
Mailing address:
  • Phone: 516-938-5830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR045131-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: