Provider Demographics
NPI:1578585733
Name:SCHWARTZ, SUSAN EVALYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:EVALYN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 E DENTON LN
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-7508
Mailing Address - Country:US
Mailing Address - Phone:602-508-8761
Mailing Address - Fax:
Practice Address - Street 1:3625 E DENTON LN
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-7508
Practice Address - Country:US
Practice Address - Phone:602-508-8761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1863103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PHD1863Medicare ID - Type Unspecified