Provider Demographics
NPI:1114392453
Name:RISA SWELL, LCSW, CEAP, LLC
Entity Type:Organization
Organization Name:RISA SWELL, LCSW, CEAP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CEAP
Authorized Official - Phone:856-905-2303
Mailing Address - Street 1:9 COLLAGE LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-5108
Mailing Address - Country:US
Mailing Address - Phone:856-905-2303
Mailing Address - Fax:
Practice Address - Street 1:2301 E EVESHAM RD STE 109
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4502
Practice Address - Country:US
Practice Address - Phone:856-905-2303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-12
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC008684001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty