Provider Demographics
NPI:1083784599
Name:SCHWARTZ, BEVERLY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BEVERLY
Other - Middle Name:
Other - Last Name:RAYNOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:833 SW 11TH AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2125
Mailing Address - Country:US
Mailing Address - Phone:503-227-5692
Mailing Address - Fax:503-227-8183
Practice Address - Street 1:833 SW 11TH AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2125
Practice Address - Country:US
Practice Address - Phone:503-227-5692
Practice Address - Fax:503-227-8183
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL20481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical