Provider Demographics
NPI:1497800221
Name:SWERDLOW-BRANDT, JOAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:SWERDLOW-BRANDT
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 1:100 KING ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3243
Mailing Address - Country:US
Mailing Address - Phone:413-586-6542
Mailing Address - Fax:413-586-7533
Practice Address - Street 1:100 KING ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3243
Practice Address - Country:US
Practice Address - Phone:413-586-6542
Practice Address - Fax:413-586-7533
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1051991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA105199OtherLICENSE- LICSW
MAPO3289Medicare ID - Type Unspecified