Provider Demographics
NPI:1528163433
Name:SCHWARTZ, CAROL PAULA (PHD, LLC)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:PAULA
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:PHD, LLC
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:PAULA
Other - Last Name:KRENTZEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:600 WORCESTER RD STE 501
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5316
Mailing Address - Country:US
Mailing Address - Phone:978-764-6574
Mailing Address - Fax:
Practice Address - Street 1:223 WALNUT STREET
Practice Address - Street 2:SUITE 20
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7500
Practice Address - Country:US
Practice Address - Phone:508-872-8208
Practice Address - Fax:978-440-9455
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4488103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW04326Medicare UPIN