Provider Demographics
NPI:1568412674
Name:SWAIN, LAURIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:
Last Name:SWAIN
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 1:100 E PLEASURE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7710
Mailing Address - Country:US
Mailing Address - Phone:501-305-4068
Mailing Address - Fax:501-279-3760
Practice Address - Street 1:100 E PLEASURE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7710
Practice Address - Country:US
Practice Address - Phone:501-305-4068
Practice Address - Fax:501-279-3760
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1915-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP58886Medicare UPIN
AR5Y373Medicare ID - Type Unspecified