Provider Demographics
NPI:1801107149
Name:SCHWARTZ, DINA NANCY (LMSW)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:NANCY
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-4040
Mailing Address - Country:US
Mailing Address - Phone:315-253-0361
Mailing Address - Fax:
Practice Address - Street 1:1401 CLAYTON MANOR DR APT 7
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-5372
Practice Address - Country:US
Practice Address - Phone:315-218-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077279-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical