Provider Demographics
NPI:1831528041
Name:SWARTZ, ELISA
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4490 ELDORADO PKWY
Mailing Address - Street 2:1038
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3770
Mailing Address - Country:US
Mailing Address - Phone:469-450-4885
Mailing Address - Fax:
Practice Address - Street 1:305 E MCDERMOTT DR STE A
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-2851
Practice Address - Country:US
Practice Address - Phone:972-984-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63802101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional