Provider Demographics
NPI:1003960170
Name:SWIFT, LAURIE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:MSW, LCSW
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 872
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-0872
Mailing Address - Country:US
Mailing Address - Phone:973-479-2231
Mailing Address - Fax:
Practice Address - Street 1:92 BROADWAY
Practice Address - Street 2:SUITE 203
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2761
Practice Address - Country:US
Practice Address - Phone:973-627-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC048030001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP2751728OtherOXFORD HEALTH PLANS
NJP2751728OtherOXFORD HEALTH PLANS