Provider Demographics
NPI:1629182092
Name:MCSWEEN, JACQUELINE JUNE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:JUNE
Last Name:MCSWEEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENWOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-3710
Mailing Address - Country:US
Mailing Address - Phone:856-309-1936
Mailing Address - Fax:856-309-1936
Practice Address - Street 1:3900 WOODLAND AVE
Practice Address - Street 2:SOCIAL WORK 222
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4551
Practice Address - Country:US
Practice Address - Phone:215-823-5964
Practice Address - Fax:215-823-4558
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0150341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical