Basic Information
Provider Information
NPI: 1275045296
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWARTZ
FirstName: CYNTHIA
MiddleName:  
NamePrefix: PROF.
NameSuffix:  
Credential: LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11681 NW 13TH MNR
Address2:  
City: CORAL SPRINGS
State: FL
PostalCode: 330714105
CountryCode: US
TelephoneNumber: 9546325398
FaxNumber:  
Practice Location
Address1: 7481 W OAKLAND PARK BLVD STE 100
Address2:  
City: TAMARAC
State: FL
PostalCode: 333194985
CountryCode: US
TelephoneNumber: 9547717743
FaxNumber: 9547717748
Other Information
ProviderEnumerationDate: 10/31/2017
LastUpdateDate: 12/05/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XSW14891FLY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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