Provider Demographics
NPI:1659335990
Name:SCHWEIGER, RUSSELL A (LISW)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:A
Last Name:SCHWEIGER
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 7391
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88006
Mailing Address - Country:US
Mailing Address - Phone:575-915-6700
Mailing Address - Fax:
Practice Address - Street 1:5320 WILL RUTH AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-5430
Practice Address - Country:US
Practice Address - Phone:915-755-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI05690104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM79235085Medicaid
Q31196Medicare UPIN
NM79235085Medicaid