Provider Demographics
NPI:1831303940
Name:SWANSON, JOAN LINNEA (CSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:LINNEA
Last Name:SWANSON
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W END AVE
Mailing Address - Street 2:SUITE #1G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6131
Mailing Address - Country:US
Mailing Address - Phone:212-769-2200
Mailing Address - Fax:212-769-0113
Practice Address - Street 1:140 W END AVE
Practice Address - Street 2:SUITE #1G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6131
Practice Address - Country:US
Practice Address - Phone:212-769-2200
Practice Address - Fax:212-769-0113
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037481-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY209384OtherMANAGED HEALTH NETWORK
NYR037481OtherHIP PROVIDER NUMBER
NYP1269263OtherOXFORD HEALTH PLANS