Provider Demographics
NPI:1790972917
Name:SCHWARTZ, ALYSE PAM
Entity Type:Individual
Prefix:
First Name:ALYSE
Middle Name:PAM
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 NORTHWEST DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-1534
Mailing Address - Country:US
Mailing Address - Phone:860-793-4200
Mailing Address - Fax:
Practice Address - Street 1:45 HARTFORD TPKE
Practice Address - Street 2:STE 2
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-5274
Practice Address - Country:US
Practice Address - Phone:860-647-8995
Practice Address - Fax:860-647-6930
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker