Individual provider Active NPI

Gunther Luther Schwartz, PHD

  • Clinical Psychologist
  • Cadillac, MI
National Provider Identifier
1235145384
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301019247 Issued in MI
Practice address
805 S Carmel St
Cadillac, MI 49601-2344
Phone
(231) 775-6517
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301019247 MI Primary

Addresses

Primary practice location

805 S Carmel St
Cadillac, MI 49601-2344

Mailing address

805 S Carmel St
Cadillac, MI 49601-2344
Phone (231) 775-6517

Other identifiers 1

IdentifierTypeStateIssuer
P10D112750OtherMIBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230203001401 MI Practitioner - Clinical Psychologist 7012389828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifeskills Psychological Services PCGroup PAC ID 2961677265, 7 clinicians

Practice addresses (Care Compare)

805 S Carmel St
Cadillac, MI 49601-2344
Phone (231) 775-6517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeskills Psychological Services PC CurrentSince Dec 30, 2022 Accepting new patients

Locations

811 Sunnyside Dr
Cadillac, MI 49601
Phone (231) 715-1015

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1235145384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 S CARMEL ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012344",
            "telephone_number": "231-775-6517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S CARMEL ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012344",
            "telephone_number": "231-775-6517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "GUNTHER",
        "middle_name": "LUTHER",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301019247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "P10D112750",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.