Individual provider Active NPI

Theresa Kay Schwartz, LMSW

  • Clinical Social Worker
  • Southgate, MI
National Provider Identifier
1912550757
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114362 Issued in MI
Practice address
1 Heritage Dr Ste 261
Southgate, MI 48195-2574
Phone
(734) 778-0663
Fax
(734) 785-8328
NPI assigned
Jul 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801114362 MI Primary

Addresses

Primary practice location

1 Heritage Dr Ste 261
Southgate, MI 48195-2574

Mailing address

1 Heritage Dr Ste 261
Southgate, MI 48195-2574
Phone (734) 778-0663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801114362MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Counseling L.L.C. Clinical CurrentSince Apr 17, 2022 Accepting new patients
Healing 4 Peace Therapy PLLC Current Accepting new patients
Psygenics Inc Clinical PastSince Feb 1, 2020 Accepting new patients

Locations

1 Heritage Dr
Ste 261
Southgate, MI 48195
Phone (734) 778-0663

2514 Biddle Ave
Wyandotte, MI 48192
Phone (313) 283-0821

Organizations & group practices 3

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": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1912550757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HERITAGE DR STE 261",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952574",
            "telephone_number": "734-778-0663",
            "fax_number": "734-785-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HERITAGE DR STE 261",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952574",
            "telephone_number": "734-778-0663",
            "fax_number": "734-785-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "THERESA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.