Provider Demographics
NPI:1942552880
Name:SCHWARTZ, WENDY THEDER (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:THEDER
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7626
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-8948
Mailing Address - Country:US
Mailing Address - Phone:414-378-7252
Mailing Address - Fax:414-383-4522
Practice Address - Street 1:16-2144 OHIA DR
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-7762
Practice Address - Country:US
Practice Address - Phone:414-378-7252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI128731-121171M00000X
HI43741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator