Provider Demographics
NPI:1003889486
Name:SWENSON, GERALD A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:A
Last Name:SWENSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2834 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2730
Mailing Address - Country:US
Mailing Address - Phone:914-245-7598
Mailing Address - Fax:914-245-3574
Practice Address - Street 1:1940 COMMERCE ST
Practice Address - Street 2:SUITE 109
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4428
Practice Address - Country:US
Practice Address - Phone:914-245-7598
Practice Address - Fax:914-245-3574
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0408441041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01546152Medicaid
393384OtherMVP
5C3147OtherHEALTHNET
NY7484380OtherEMPIRE VALUE OPTIONS
NYR040844OtherHIP OF NY
1031500OtherBEACON HEALTH STRATEGIES
6251182OtherUNITED BEHAVIORAL HEALTH
7936068OtherAETNA
212049OtherMHN
P651419OtherOXFORD
6251182OtherUNITED BEHAVIORAL HEALTH