Provider Demographics
NPI:1245567452
Name:SCHWARZ, JASON R (CAC, CADC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:R
Last Name:SCHWARZ
Suffix:
Gender:M
Credentials:CAC, CADC
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Other - Credentials:
Mailing Address - Street 1:88 GRANDVIEW AVE FL 2
Mailing Address - Street 2:WEST MAIN BEHAVIORAL HEALTH - WATERBURY HOSPITAL
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2509
Mailing Address - Country:US
Mailing Address - Phone:203-573-7500
Mailing Address - Fax:203-573-6575
Practice Address - Street 1:88 GRANDVIEW AVE FL 2
Practice Address - Street 2:WEST MAIN BEHAVIORAL HEALTH - WATERBURY HOSPITAL
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2509
Practice Address - Country:US
Practice Address - Phone:203-573-7500
Practice Address - Fax:203-573-6575
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2014-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT000635101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)