Provider Demographics
NPI:1154679298
Name:SCHWARTZBERG, MAXIMILLIAN Y (CASAC/ MHC-LP)
Entity Type:Individual
Prefix:MR
First Name:MAXIMILLIAN
Middle Name:Y
Last Name:SCHWARTZBERG
Suffix:
Gender:M
Credentials:CASAC/ MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 77TH ST
Mailing Address - Street 2:BMT #2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3243
Mailing Address - Country:US
Mailing Address - Phone:718-833-3320
Mailing Address - Fax:718-833-2422
Practice Address - Street 1:408 77TH ST
Practice Address - Street 2:BMT #2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3243
Practice Address - Country:US
Practice Address - Phone:718-833-3320
Practice Address - Fax:718-833-2422
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23587101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)