Provider Demographics
NPI:1851495352
Name:SWANSON, JUDY (LICSW)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:SWANSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAIN ST
Mailing Address - Street 2:COOLEY DICKINSON HOSPITAL - OPT BEHAVIORAL HEALTH
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-3158
Mailing Address - Country:US
Mailing Address - Phone:413-586-8550
Mailing Address - Fax:413-586-9765
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:COOLEY DICKINSON HOSPITAL - OPT BEHAVIORAL HEALTH
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-3158
Practice Address - Country:US
Practice Address - Phone:413-586-8550
Practice Address - Fax:413-586-9765
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10183951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical