Provider Demographics
NPI:1063825057
Name:SWIRE, KIM ANDERSON (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:ANDERSON
Last Name:SWIRE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S MANNING BLVD
Mailing Address - Street 2:CHOICES PROGRAM
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1707
Mailing Address - Country:US
Mailing Address - Phone:518-525-1604
Mailing Address - Fax:518-525-1075
Practice Address - Street 1:315 S MANNING BLVD
Practice Address - Street 2:CHOICES PROGRAM
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1707
Practice Address - Country:US
Practice Address - Phone:518-525-1604
Practice Address - Fax:518-525-1075
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020367-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker