Provider Demographics
NPI:1003983636
Name:SCHWAGER, GARY (LPC)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:SCHWAGER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2783
Mailing Address - Country:US
Mailing Address - Phone:919-903-3182
Mailing Address - Fax:415-833-9427
Practice Address - Street 1:122 W. VERNON ST.
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587
Practice Address - Country:US
Practice Address - Phone:919-903-3182
Practice Address - Fax:919-554-9232
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPC 10930101YM0800X, 101YP2500X
NC10930101YP2500X
CAMFC39143106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist