Provider Demographics
NPI:1225346166
Name:SWAN, PRISCILLA N (MSW)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:N
Last Name:SWAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 VANDAM ST
Mailing Address - Street 2:7TH FLOOR - PROS MANHATTAN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-1009
Mailing Address - Country:US
Mailing Address - Phone:212-366-8218
Mailing Address - Fax:212-366-8139
Practice Address - Street 1:80 VANDAM ST
Practice Address - Street 2:7TH FLOOR - PROS MANHATTAN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1009
Practice Address - Country:US
Practice Address - Phone:212-366-8218
Practice Address - Fax:212-366-8139
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078052-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker