Provider Demographics
NPI:1013335652
Name:SCHWARTZ, JASON FRANCIS (LMSW)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:FRANCIS
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11245 W CLEMENTS CIR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3100
Mailing Address - Country:US
Mailing Address - Phone:734-776-1679
Mailing Address - Fax:
Practice Address - Street 1:6633 STONY CREEK RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-6609
Practice Address - Country:US
Practice Address - Phone:734-485-8725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
MI68010784071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)