Provider Demographics
NPI:1821655077
Name:SWARTZENDRUBER, TONYA (LMHC)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:SWARTZENDRUBER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:TONYAQ
Other - Middle Name:
Other - Last Name:SWARTZENDRUBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:33 LYDECKER ST
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-2103
Mailing Address - Country:US
Mailing Address - Phone:347-494-8926
Mailing Address - Fax:
Practice Address - Street 1:48 BURD ST STE 305
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3259
Practice Address - Country:US
Practice Address - Phone:347-494-8926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health