Provider Demographics
NPI:1801139977
Name:SCHWARTZ, JANICE ELLEN (LCSWR)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:ELLEN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:ELLEN
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSWR
Mailing Address - Street 1:1729 BURRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1001
Mailing Address - Country:US
Mailing Address - Phone:315-798-1702
Mailing Address - Fax:
Practice Address - Street 1:1729 BURRSTONE RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1001
Practice Address - Country:US
Practice Address - Phone:315-798-1702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0518101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY051810OtherLICENSE