Provider Demographics
NPI:1407163918
Name:SCHWAN-ROSENWALD, LILI
Entity Type:Individual
Prefix:MRS
First Name:LILI
Middle Name:
Last Name:SCHWAN-ROSENWALD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2232
Mailing Address - Country:US
Mailing Address - Phone:800-455-8726
Mailing Address - Fax:866-455-8839
Practice Address - Street 1:687 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2232
Practice Address - Country:US
Practice Address - Phone:800-455-8726
Practice Address - Fax:866-455-8839
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health