Provider Demographics
NPI:1073653614
Name:SWAIN, JASON MATTHEW (LCSW)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:MATTHEW
Last Name:SWAIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 WATT AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-6200
Mailing Address - Country:US
Mailing Address - Phone:916-979-3556
Mailing Address - Fax:916-979-3503
Practice Address - Street 1:2829 WATT AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6200
Practice Address - Country:US
Practice Address - Phone:916-979-3556
Practice Address - Fax:916-979-3503
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA227691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical