Provider Demographics
NPI:1043301302
Name:SCHWARTZ, EILEEN (PHD)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SLOCUM RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3043
Mailing Address - Country:US
Mailing Address - Phone:617-283-7925
Mailing Address - Fax:617-553-0631
Practice Address - Street 1:34 SLOCUM RD
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3043
Practice Address - Country:US
Practice Address - Phone:617-283-7925
Practice Address - Fax:617-553-0631
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2982103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW03203OtherBLUE CROSS BLUE SHIELD
MAW03203OtherBLUE CROSS BLUE SHIELD
MAW03203Medicare ID - Type Unspecified