Provider Demographics
NPI:1700370350
Name:SCHWARTZ, MARY SUSAN (MSW, LAICSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:SUSAN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MSW, LAICSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:SUSAN
Other - Last Name:EASTLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LAICSW
Mailing Address - Street 1:10740 MERIDIAN AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9010
Mailing Address - Country:US
Mailing Address - Phone:206-235-5956
Mailing Address - Fax:
Practice Address - Street 1:10740 MERIDIAN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9010
Practice Address - Country:US
Practice Address - Phone:206-235-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60837082104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker