Healthcare Provider Details

I. General information

NPI: 1134137631
Provider Name (Legal Business Name): MICHAEL E SCHWARTZ PSYD., MSCP.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SULLIVAN AVE STE 2-5
FERNDALE NY
12734-4317
US

IV. Provider business mailing address

111 SULLIVAN AVE STE 2-5
FERNDALE NY
12734-4317
US

V. Phone/Fax

Practice location:
  • Phone: 845-292-6222
  • Fax: 845-292-2222
Mailing address:
  • Phone: 845-292-6222
  • Fax: 845-292-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY-2024-0011
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number68-15434
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY-2024-0011
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY-2024-0011
License Number StateNM
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number68-15434
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number68-15434
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number68-15434
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberPSY-2024-0011
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: