Provider Demographics
NPI:1386265049
Name:SWANSON, LAURA EMILY (MSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:EMILY
Last Name:SWANSON
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 1:55 TIEMANN PL APT 57
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-3338
Mailing Address - Country:US
Mailing Address - Phone:716-720-1637
Mailing Address - Fax:
Practice Address - Street 1:535 CLINTON AVE STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-6590
Practice Address - Country:US
Practice Address - Phone:716-268-1379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker