Provider Demographics
NPI:1568953370
Name:SCHWIMMER, CARLEEN GRAHAM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARLEEN
Middle Name:GRAHAM
Last Name:SCHWIMMER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14120 W SIDE BLVD APT 305
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6219
Mailing Address - Country:US
Mailing Address - Phone:860-558-6052
Mailing Address - Fax:
Practice Address - Street 1:VETERANS AFFAIRS WAR RELATED ILLNESS & INJURY (WRIISC)
Practice Address - Street 2:50 IRVING STREET NW
Practice Address - City:WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20707
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05743103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist