Provider Demographics
NPI:1992862841
Name:SCHWARZ, LISA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:SCHWARZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:CASELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:66 9TH ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2911
Mailing Address - Country:US
Mailing Address - Phone:718-496-2073
Mailing Address - Fax:
Practice Address - Street 1:66 9TH ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2911
Practice Address - Country:US
Practice Address - Phone:718-351-4817
Practice Address - Fax:718-351-4817
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011811103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical