Provider Demographics
NPI:1740423821
Name:SCHATZ, MARY T (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:T
Last Name:SCHATZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 ELMGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4222
Mailing Address - Country:US
Mailing Address - Phone:401-439-7325
Mailing Address - Fax:
Practice Address - Street 1:340 BROADWAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1102
Practice Address - Country:US
Practice Address - Phone:401-273-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW005711041C0700X
MA1046751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical