Provider Demographics
NPI:1578108783
Name:SWAN THERAPY GROUP LLC
Entity Type:Organization
Organization Name:SWAN THERAPY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWANER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-966-4166
Mailing Address - Street 1:252 WASHINGTON ST STE B2
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7582
Mailing Address - Country:US
Mailing Address - Phone:732-966-4166
Mailing Address - Fax:
Practice Address - Street 1:252 WASHINGTON ST STE B2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7582
Practice Address - Country:US
Practice Address - Phone:732-966-4166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty