Provider Demographics
NPI:1093443186
Name:SWIFT, MARY MARJORIE (LCSW, LISW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARJORIE
Last Name:SWIFT
Suffix:
Gender:F
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:SWIFT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:7901 4TH ST N # 21502
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:941-212-0227
Mailing Address - Fax:
Practice Address - Street 1:7901 4TH ST N # 21502
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4305
Practice Address - Country:US
Practice Address - Phone:941-212-0227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.24052291041C0700X
VA09040152851041C0700X
FLSW175301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical