MEDICARE: MR. DAVID JASON SCHWARTZ M.A.

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	103T00000X	Psychologist	012181	MI
2	103TC2200X	Clinical Child & Adolescent Psychologist
3	103TC0700X	Clinical Psychologist	012181	MI

General Provider Information

NPI Number	:	1861439457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID JASON SCHWARTZ M.A.

Provider Business Mailing Address
First Line	:	33045 HAMILTON CT
Second Line	:	SUITE W-300
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3385
Country	:	US
Telephone Number	:	248-848-1558
Fax Number	:	248-848-3592

Provider Business Practice Location Address
First Line	:	21611 E 11 MILE RD
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48081-1636
Country	:	US
Telephone Number	:	586-944-2902
Fax Number	:

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	05/08/2026

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