Healthcare Provider Details
I. General information
NPI: 1710066063
Provider Name (Legal Business Name): THOMAS A SCHWEINBERG PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/06/2006
Last Update Date: 12/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3345 GLENMORE AVE
CINCINNATI OH
45211-6543
US
IV. Provider business mailing address
4075 OLD WESTERN ROW RD
MASON OH
45040-3104
US
V. Phone/Fax
- Phone: 513-481-7500
- Fax: 513-481-6316
- Phone: 513-536-0232
- Fax: 513-536-0609
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 5211 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: