MEDICARE: KATHRYN ANNE SCHWARZ MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC.0016724	CO

General Provider Information

NPI Number	:	1558966168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN ANNE SCHWARZ MA

Provider Business Mailing Address
First Line	:	2818 13TH ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3518
Country	:	US
Telephone Number	:	303-440-5140
Fax Number	:

Provider Business Practice Location Address
First Line	:	1086 10TH ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80302-7261
Country	:	US
Telephone Number	:
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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