Provider Demographics
NPI:1518177336
Name:SCHWARTZ, CAROL A (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 931892
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90093-1892
Mailing Address - Country:US
Mailing Address - Phone:323-688-6141
Mailing Address - Fax:
Practice Address - Street 1:7221 OUTPOST COVE DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-2009
Practice Address - Country:US
Practice Address - Phone:323-688-6141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 169151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW16915BMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER