Provider Demographics
NPI:1396794178
Name:SCHWARTZ, MARY VIRGINIA (LMHC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:VIRGINIA
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 W PLATT
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060
Mailing Address - Country:US
Mailing Address - Phone:563-652-4958
Mailing Address - Fax:
Practice Address - Street 1:714 W PLATT
Practice Address - Street 2:
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060
Practice Address - Country:US
Practice Address - Phone:563-652-4958
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00751101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health