Provider Demographics
NPI:1881798163
Name:SWANZY, BERNADINE ELEANOR (LMSW)
Entity type:Individual
Prefix:MRS
First Name:BERNADINE
Middle Name:ELEANOR
Last Name:SWANZY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W WALCH AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4041
Mailing Address - Country:US
Mailing Address - Phone:830-997-3263
Mailing Address - Fax:
Practice Address - Street 1:KERRVILLE VA MEDICAL CENTER
Practice Address - Street 2:MEMORIAL BLVD
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-896-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX059211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical