Provider Demographics
NPI:1912550757
Name:SCHWARTZ, THERESA KAY (LMSW)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:KAY
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HERITAGE DR STE 261
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2574
Mailing Address - Country:US
Mailing Address - Phone:734-778-0663
Mailing Address - Fax:734-785-8328
Practice Address - Street 1:1 HERITAGE DR STE 261
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2574
Practice Address - Country:US
Practice Address - Phone:734-778-0663
Practice Address - Fax:734-785-8328
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011143621041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical