Provider Demographics
NPI:1558988394
Name:SWIMS, MARY BIBB
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:BIBB
Last Name:SWIMS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 RENAISSANCE PKWY NE APT 113
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2349
Mailing Address - Country:US
Mailing Address - Phone:845-706-3221
Mailing Address - Fax:
Practice Address - Street 1:1030 KINGS HWY N STE 202
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1907
Practice Address - Country:US
Practice Address - Phone:201-820-0057
Practice Address - Fax:617-807-0958
Is Sole Proprietor?:No
Enumeration Date:2020-06-27
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0069511041C0700X
NJ44SC059998001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical