Provider Demographics
NPI:1285113191
Name:SCHWARTZ, DAVID ANDREW (LICSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:LICSW
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 2484
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-2484
Mailing Address - Country:US
Mailing Address - Phone:163-155-3901
Mailing Address - Fax:
Practice Address - Street 1:2444 MAIN ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:NH
Practice Address - Zip Code:03574-4916
Practice Address - Country:US
Practice Address - Phone:603-869-0087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NH24051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker