Healthcare Provider Details

I. General information

NPI: 1083199103
Provider Name (Legal Business Name): DARA MCLEAN SCHWARTZ MA, MED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 DELAWARE AVE
FOUNTAIN HILL PA
18015-1174
US

IV. Provider business mailing address

420 WHITE OAK RD
LEHIGHTON PA
18235-5946
US

V. Phone/Fax

Practice location:
  • Phone: 610-419-3101
  • Fax:
Mailing address:
  • Phone: 610-858-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: