Provider Demographics
NPI:1598724270
Name:SCHWARTZ, BARBARA KATHRYN (MA, LP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:KATHRYN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MA, LP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:KATHERINE
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA,LP
Mailing Address - Street 1:8041 113TH ST S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-4510
Mailing Address - Country:US
Mailing Address - Phone:651-493-2846
Mailing Address - Fax:651-493-2847
Practice Address - Street 1:2446 UNIVERSITY AVE W
Practice Address - Street 2:# 130
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-0001
Practice Address - Country:US
Practice Address - Phone:651-493-2846
Practice Address - Fax:651-493-2847
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2560103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN167J5SCOtherBLUE CROSS BLUE SHIELD
MN352301-000OtherMAGELLAN
MN6245959OtherMEDICA
MN5160545-00OtherMEDICAL ASSISTANCE