Provider Demographics
NPI:1154026193
Name:ROBERTS, SWAN E (LCSW)
Entity type:Individual
Prefix:
First Name:SWAN
Middle Name:E
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SWAM
Other - Middle Name:EDEL
Other - Last Name:ELGUERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3609 NICKOLAS TRL
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-8180
Mailing Address - Country:US
Mailing Address - Phone:502-640-2019
Mailing Address - Fax:
Practice Address - Street 1:303 E COURT AVE, JEFFERSONVILLE, IN 47130
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130
Practice Address - Country:US
Practice Address - Phone:786-755-1863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34010313A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical