Provider Demographics
NPI:1457566952
Name:SCHWARTZ, CHARLES DANIEL (MA, LPC, NCC, NCSC)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:DANIEL
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MA, LPC, NCC, NCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 TRAPPERS RUN CT
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9311
Mailing Address - Country:US
Mailing Address - Phone:336-841-8287
Mailing Address - Fax:
Practice Address - Street 1:986 HUTTON ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-5716
Practice Address - Country:US
Practice Address - Phone:336-727-2310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3536101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool