Provider Demographics
NPI:1831393057
Name:SCHWENKER, JASON (PSYD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:SCHWENKER
Suffix:
Gender:M
Credentials:PSYD
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 5344
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-5344
Mailing Address - Country:US
Mailing Address - Phone:406-818-5442
Mailing Address - Fax:406-818-5212
Practice Address - Street 1:14 2ND ST W STE 16
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-3035
Practice Address - Country:US
Practice Address - Phone:406-818-5442
Practice Address - Fax:406-818-5212
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY161603103TC0700X
MTPSY-PSY-LIC-2980103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical