1669866380 NPI number — MISS HELENE DARA SCHWARTZ MSW, RCSWI

Table of content: MISS HELENE DARA SCHWARTZ MSW, RCSWI (NPI 1669866380)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669866380 NPI number — MISS HELENE DARA SCHWARTZ MSW, RCSWI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARTZ
Provider First Name:
HELENE
Provider Middle Name:
DARA
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MSW, RCSWI
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RUSS
Provider Other First Name:
HELENE
Provider Other Middle Name:
DARA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW, RCSWI
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669866380
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 VONDERBURG DR
Provider Second Line Business Mailing Address:
SUITE 301
Provider Business Mailing Address City Name:
BRANDON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33511-5954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-881-1000
Provider Business Mailing Address Fax Number:
813-689-2684

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 VONDERBURG DR
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
BRANDON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33511-5954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-881-1000
Provider Business Practice Location Address Fax Number:
813-689-2684
Provider Enumeration Date:
03/19/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  ISW 9273 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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