Healthcare Provider Details

I. General information

NPI: 1396180584
Provider Name (Legal Business Name): STACEY SCHWARTZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BARR HARBOR DR STE
W CNSHOHOCKEN PA
19428-2978
US

IV. Provider business mailing address

5 VERA LN
CONSHOHOCKEN PA
19428-2113
US

V. Phone/Fax

Practice location:
  • Phone: 484-362-9802
  • Fax: 888-343-2014
Mailing address:
  • Phone: 610-825-4450
  • Fax: 610-941-5532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017571
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

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: