Provider Demographics
NPI:1285071373
Name:SCHWARTZ, MERRILY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MERRILY
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E 125TH CT S
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-1076
Mailing Address - Country:US
Mailing Address - Phone:918-639-7098
Mailing Address - Fax:918-528-6888
Practice Address - Street 1:315 E 125TH CT S
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-1076
Practice Address - Country:US
Practice Address - Phone:918-639-7098
Practice Address - Fax:918-528-6888
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK09561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical