Provider Demographics
NPI:1750666871
Name:SWENSON, MELANEY (LCSW)
Entity Type:Individual
Prefix:
First Name:MELANEY
Middle Name:
Last Name:SWENSON
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:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-0142
Mailing Address - Country:US
Mailing Address - Phone:406-548-4104
Mailing Address - Fax:
Practice Address - Street 1:11 W MAIN ST STE B3
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714
Practice Address - Country:US
Practice Address - Phone:406-548-4104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW - 276461041C0700X
MTBBH-LCSW-LIC-83741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical