Provider Demographics
NPI:1013146356
Name:SCHWEITZER, LISA CARYN
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:CARYN
Last Name:SCHWEITZER
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 1:120 22ND AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-3206
Mailing Address - Country:US
Mailing Address - Phone:404-514-8628
Mailing Address - Fax:
Practice Address - Street 1:8800 49TH ST
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-5353
Practice Address - Country:US
Practice Address - Phone:727-542-3635
Practice Address - Fax:727-865-5178
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH7473101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health