Provider Demographics
NPI:1982707949
Name:SCHWARTZ, SCOTT LAWRENCE (PH D)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LAWRENCE
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 12TH ST
Mailing Address - Street 2:JOHN UMSTEAD HOSPITAL/CPI
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509-1626
Mailing Address - Country:US
Mailing Address - Phone:919-575-2128
Mailing Address - Fax:919-575-7859
Practice Address - Street 1:1003 12TH ST
Practice Address - Street 2:JOHN UMSTEAD HOSPITAL/CPI
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-1626
Practice Address - Country:US
Practice Address - Phone:919-575-2128
Practice Address - Fax:919-575-7859
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2883103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical