Provider Demographics
NPI:1346820115
Name:SWAN, SYDNEY (MSW)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:SWAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 BURNT MILL DR STE 1
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2570
Mailing Address - Country:US
Mailing Address - Phone:910-726-9192
Mailing Address - Fax:910-796-8111
Practice Address - Street 1:3240 BURNT MILL DR STE 1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-2570
Practice Address - Country:US
Practice Address - Phone:910-726-9192
Practice Address - Fax:910-796-8111
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health