Provider Demographics
NPI:1184709552
Name:SWAGGER, SCOTT JAMES (MS)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:JAMES
Last Name:SWAGGER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S 84TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2606
Mailing Address - Country:US
Mailing Address - Phone:402-484-8898
Mailing Address - Fax:402-484-8898
Practice Address - Street 1:211 S 84TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2606
Practice Address - Country:US
Practice Address - Phone:402-484-8898
Practice Address - Fax:402-484-8898
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1761106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE85044Medicare UPIN
NE10265Medicare UPIN