Provider Demographics
NPI:1538467774
Name:SCHWARTZ, JENNIFER ANNE (LICSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 ANN LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9390
Mailing Address - Country:US
Mailing Address - Phone:612-644-4734
Mailing Address - Fax:
Practice Address - Street 1:117 ANN LN
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-9390
Practice Address - Country:US
Practice Address - Phone:612-644-4734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-309611041C0700X
WALW601086311041C0700X
NCC0077711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical