Provider Demographics
NPI:1356885800
Name:SWENCKI, MELANIE (LCSW)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:SWENCKI
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 1:193 SAINT CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18705-2710
Mailing Address - Country:US
Mailing Address - Phone:570-241-5831
Mailing Address - Fax:
Practice Address - Street 1:193 SAINT CLAIR ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18705-2710
Practice Address - Country:US
Practice Address - Phone:570-241-5831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0193141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical