Healthcare Provider Details

I. General information

NPI: 1629273503
Provider Name (Legal Business Name): AUDREY SCHWARTZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 09/15/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 RIVER RD
EUGENE OR
97404-3242
US

IV. Provider business mailing address

1292 HIGH ST # 323
EUGENE OR
97401-3238
US

V. Phone/Fax

Practice location:
  • Phone: 541-393-2339
  • Fax:
Mailing address:
  • Phone: 541-393-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7023
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: