Provider Demographics
NPI:1679807945
Name:SCHWARTZ, JUDITH (LPC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7578 LEGLER ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66217-3023
Mailing Address - Country:US
Mailing Address - Phone:913-948-1338
Mailing Address - Fax:
Practice Address - Street 1:8889 BOURGADE ST
Practice Address - Street 2:SUITE 127
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1403
Practice Address - Country:US
Practice Address - Phone:913-948-1338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-19
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC 980101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200637440AMedicaid