Healthcare Provider Details

I. General information

NPI: 1750172425
Provider Name (Legal Business Name): JENNA SWINKOWSKI LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17937 HALL RD
MACOMB MI
48044-4557
US

IV. Provider business mailing address

36619 CRIMSON LN
NEW BALTIMORE MI
48047-5588
US

V. Phone/Fax

Practice location:
  • Phone: 586-839-5622
  • Fax:
Mailing address:
  • Phone: 586-859-8838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: