Provider Demographics
NPI:1447961743
Name:SCHWARTZ, EDEN (LCMHCA)
Entity type:Individual
Prefix:
First Name:EDEN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1573
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:NC
Mailing Address - Zip Code:28729-1573
Mailing Address - Country:US
Mailing Address - Phone:843-345-3326
Mailing Address - Fax:
Practice Address - Street 1:23 S BROAD ST STE 106
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-5140
Practice Address - Country:US
Practice Address - Phone:828-484-2054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18427101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional