Provider Demographics
NPI:1295115319
Name:SHWEKY, LAWRENCE (LCSW)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:SHWEKY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 PICASSO AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-0505
Mailing Address - Country:US
Mailing Address - Phone:916-992-4618
Mailing Address - Fax:
Practice Address - Street 1:2043 PICASSO AVE
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-0505
Practice Address - Country:US
Practice Address - Phone:916-992-4618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS192121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical