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General NPI Number Information
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NPI Number | 1942552880
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Entity Type | Individual
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Provider Name | WENDY THEDER SCHWARTZ MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 16-2144 OHIA DR
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City | PAHOA
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State | HI
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Zip | 96778-7762
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Country | US
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Telephone | 414-378-7252
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7626
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City | HILO
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State | HI
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Zip | 96720-8948
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Country | US
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Telephone | 414-378-7252
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Fax | 414-383-4522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 128731-121
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4374
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License Number State | HI
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