Healthcare Provider Details

I. General information

NPI: 1215208509
Provider Name (Legal Business Name): GEOFFREY L SCHWERZLER PSY. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2012
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 5021
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE ML 3015
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4225
  • Fax: 513-636-2511
Mailing address:
  • Phone: 513-636-4225
  • Fax: 513-636-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1662
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: