Provider Demographics
NPI:1053829432
Name:SCHWARTZ, SIMI (LCSW)
Entity Type:Individual
Prefix:
First Name:SIMI
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 LEEWATER AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-8314
Mailing Address - Country:US
Mailing Address - Phone:516-387-0628
Mailing Address - Fax:
Practice Address - Street 1:89 LEEWATER AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-8314
Practice Address - Country:US
Practice Address - Phone:516-387-0628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-19
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102362-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker