Provider Demographics
NPI:1912265661
Name:SCHWARTZ, MICHAEL HARVEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HARVEY
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12308
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66282-2308
Mailing Address - Country:US
Mailing Address - Phone:913-669-3536
Mailing Address - Fax:
Practice Address - Street 1:2400 FREDERICK AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2758
Practice Address - Country:US
Practice Address - Phone:913-669-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR0260103TC0700X
KS0476103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical