Healthcare Provider Details

I. General information

NPI: 1013506807
Provider Name (Legal Business Name): LAEL SCHWARTZ LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2021
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GRANDVIEW DR
READING PA
19607-3256
US

IV. Provider business mailing address

150 GRANDVIEW DR
READING PA
19607-3256
US

V. Phone/Fax

Practice location:
  • Phone: 610-781-2071
  • Fax:
Mailing address:
  • Phone: 610-781-2071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: