Healthcare Provider Details

I. General information

NPI: 1285667428
Provider Name (Legal Business Name): KAREN LOUISE SWICKER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NEWBURYPORT TPKE BOX #8
ROWLEY MA
01969-2012
US

IV. Provider business mailing address

35 WAREHOUSE LN
ROWLEY MA
01969-1508
US

V. Phone/Fax

Practice location:
  • Phone: 978-815-7421
  • Fax: 978-948-3875
Mailing address:
  • Phone: 978-815-7421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107288
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1854305
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: