Provider Demographics
NPI:1235256371
Name:SCHWARTZ, MARISSA MICHELE (MS)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:MICHELE
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:MARISSA
Other - Middle Name:MICHELE
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:835 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-5020
Mailing Address - Country:US
Mailing Address - Phone:717-239-5124
Mailing Address - Fax:
Practice Address - Street 1:2819-0 WILLOW STREET PIKE
Practice Address - Street 2:
Practice Address - City:WILLOW STREET
Practice Address - State:PA
Practice Address - Zip Code:17584
Practice Address - Country:US
Practice Address - Phone:717-464-1464
Practice Address - Fax:717-464-4348
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health