Provider Demographics
NPI:1184822207
Name:SCHWARTZ, ALISA JILL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALISA
Middle Name:JILL
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DARNALL HL
Mailing Address - Street 2:37TH AND O STREETS, NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20057-0001
Mailing Address - Country:US
Mailing Address - Phone:917-273-7038
Mailing Address - Fax:
Practice Address - Street 1:1 DARNALL HL
Practice Address - Street 2:37TH AND O STREETS, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20057-0001
Practice Address - Country:US
Practice Address - Phone:917-273-7038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015235-1103TC0700X
DCPSY1000454103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical