Provider Demographics
NPI:1194040295
Name:SWANSON, RACHEL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9441 KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1309
Mailing Address - Country:US
Mailing Address - Phone:224-723-0467
Mailing Address - Fax:847-278-5419
Practice Address - Street 1:550 FRONTAGE RD
Practice Address - Street 2:3825
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-1202
Practice Address - Country:US
Practice Address - Phone:224-723-0467
Practice Address - Fax:847-278-5419
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0137411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical