1801955943 NPI number — MR. JAMES STEPHEN SCHWARTZ MSW CADC III

Table of content: MR. JAMES STEPHEN SCHWARTZ MSW CADC III (NPI 1801955943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801955943 NPI number — MR. JAMES STEPHEN SCHWARTZ MSW CADC III

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARTZ
Provider First Name:
JAMES
Provider Middle Name:
STEPHEN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSW CADC III
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801955943
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5215 N IRONWOOD RD
Provider Second Line Business Mailing Address:
#115
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-332-4114
Provider Business Mailing Address Fax Number:
414-332-0855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5215 N IRONWOOD RD
Provider Second Line Business Practice Location Address:
#115
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-332-4114
Provider Business Practice Location Address Fax Number:
414-332-0855
Provider Enumeration Date:
12/06/2006

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: 101Y00000X , with the licence number:  4132-123 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YA0400X , with the licence number: 107 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 39508400 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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