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NPI Code Detail

MEDICARE: BREANNA SWANK LCSW

MEDICARE: BREANNA SWANK 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
1104100000XSocial Worker134636-121WI
21041C0700XClinical Social Worker12605-123WI

General Provider Information

NPI Number : 1164298295
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREANNA SWANK LCSW
Provider Business Mailing Address
First Line : 4378 S JORDAN DR APT 7
Second Line :
City : MCFARLAND
State : WI
Zip : 53558-9024
Country : US
Telephone Number : 608-669-8104
Fax Number :
Provider Business Practice Location Address
First Line : 1716 FORDEM AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-4604
Country : US
Telephone Number : 608-669-8104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2023
Last Update Date : 06/03/2026

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Directions to “ BREANNA SWANK LCSW” Practice Location

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