Provider Demographics
NPI:1073745212
Name:SCHWERDTFEGER, ELISABETH BOSTIAN (LMSW)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:BOSTIAN
Last Name:SCHWERDTFEGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4171 N CROSSOVER RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4591
Mailing Address - Country:US
Mailing Address - Phone:479-443-6496
Mailing Address - Fax:479-443-2519
Practice Address - Street 1:4171 N CROSSOVER RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4591
Practice Address - Country:US
Practice Address - Phone:479-443-6496
Practice Address - Fax:479-443-2519
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker