MEDICARE: MARIANNE S SWENSEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW5759	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053330142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANNE S SWENSEN LCSW

Provider Business Mailing Address
First Line	:	5700 LAKE WORTH RD
Second Line	:	SUITE 205
City	:	GREENACRES
State	:	FL
Zip	:	33463-4727
Country	:	US
Telephone Number	:	561-478-5160
Fax Number	:	561-642-9623

Provider Business Practice Location Address
First Line	:	5700 LAKE WORTH RD
Second Line	:	SUITE 205
City	:	GREENACRES
State	:	FL
Zip	:	33463-4727
Country	:	US
Telephone Number	:	561-478-5160
Fax Number	:	561-642-9623

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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