Provider Demographics
NPI:1336900497
Name:SCHWARTZ, MATTHEW LEWIS (MSW, RCSWI)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LEWIS
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MSW, RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 4TH ST N APT 2206
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1765
Mailing Address - Country:US
Mailing Address - Phone:551-265-2746
Mailing Address - Fax:
Practice Address - Street 1:12000 4TH ST N APT 2206
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1765
Practice Address - Country:US
Practice Address - Phone:551-265-2746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL197541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical