Provider Demographics
NPI:1518258771
Name:SWANGER, JENNIFER M (LMSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:SWANGER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:SLOSSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:579 SANDS ST
Mailing Address - Street 2:
Mailing Address - City:PENTWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49449-9548
Mailing Address - Country:US
Mailing Address - Phone:616-893-0054
Mailing Address - Fax:
Practice Address - Street 1:101 S JAMES ST STE 204
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2166
Practice Address - Country:US
Practice Address - Phone:231-233-3111
Practice Address - Fax:231-410-1014
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010984711041C0700X
101YA0400X
FLISW65301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)