Provider Demographics
NPI:1992079610
Name:SCHWARY, JOHN RAYMOND (CADAC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RAYMOND
Last Name:SCHWARY
Suffix:
Gender:M
Credentials:CADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E HUBER ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-3645
Mailing Address - Country:US
Mailing Address - Phone:602-763-2138
Mailing Address - Fax:
Practice Address - Street 1:32 S MACDONALD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-1310
Practice Address - Country:US
Practice Address - Phone:602-763-2138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2084101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)