Mark Stephen Schwartz, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY4052 Issued in FL

Practice address

12528 Charles Cove Rd
Jacksonville, FL 32246-7057

Phone

(904) 910-4122

Fax

(904) 220-0700

NPI assigned

Jan 25, 2006

Last updated

Sep 18, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Mark S Schwartz PHD Endeavors

  • Clinical Psychologist
  • Jacksonville, FL
  • NPI 1457585044
  NPD (past) Authorized official

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1538139092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12528 CHARLES COVE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467057",
            "telephone_number": "904-910-4122",
            "fax_number": "904-220-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12528 CHARLES COVE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467057",
            "telephone_number": "904-910-4122",
            "fax_number": "904-220-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY4052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Lewis Schwam, M.D.
• Marissa Schwam, RD
• Cynthia Joy Schwartz, DO
• Jonathan E. Schwartz, M.D.
• Kelly Schwartz, ORT/L
• Nancy Marie Schwartz, L.M.H.C.
• Steven H Schwartz, O.D.
• Tiffany Nichole Schwartz
• William Ivan Schwartz, D.O.
• Kea M Schwarz, RD

• Clinical Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.