Healthcare Provider Details

I. General information

NPI: 1417624685
Provider Name (Legal Business Name): VAIOLO NORA SWANAGAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BUILDING 96 MISAWA AIR BASE MHC
APO AP
96319
US

IV. Provider business mailing address

BUILDING 96
APO AP
96319
US

V. Phone/Fax

Practice location:
  • Phone: 315-226-3230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC013927
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: