Provider Demographics
NPI:1043506116
Name:SWOVERLAND, TREVOR (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:SWOVERLAND
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W SUPERIOR ST STE 620
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1723
Mailing Address - Country:US
Mailing Address - Phone:218-606-1797
Mailing Address - Fax:651-925-0039
Practice Address - Street 1:324 W SUPERIOR ST STE 620
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1723
Practice Address - Country:US
Practice Address - Phone:218-606-1797
Practice Address - Fax:651-925-0039
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN194401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical