Provider Demographics
NPI:1750180139
Name:SWAVELY, JERLDENE M (MSW, LSW)
Entity type:Individual
Prefix:
First Name:JERLDENE
Middle Name:M
Last Name:SWAVELY
Suffix:
Gender:
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:JERRI
Other - Middle Name:
Other - Last Name:SWAVELY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:205 GRANDVIEW AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1708
Mailing Address - Country:US
Mailing Address - Phone:717-425-0326
Mailing Address - Fax:
Practice Address - Street 1:205 GRANDVIEW AVE STE 404
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-1708
Practice Address - Country:US
Practice Address - Phone:717-425-0326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140740104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker