Provider Demographics
NPI:1487223509
Name:SCHWARTZ, JODI (MSW, LISW-CP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1683 INDABA WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-8012
Mailing Address - Country:US
Mailing Address - Phone:843-619-9748
Mailing Address - Fax:
Practice Address - Street 1:1683 INDABA WAY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-8012
Practice Address - Country:US
Practice Address - Phone:843-619-9748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical