Healthcare Provider Details

I. General information

NPI: 1063425171
Provider Name (Legal Business Name): JOSEPH STEPHEN SWOBODA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 UNION DR STE 206
LINCOLN NE
68516-6652
US

IV. Provider business mailing address

1018 S 35TH ST
LINCOLN NE
68510-3460
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-2218
  • Fax: 402-489-3666
Mailing address:
  • Phone: 402-488-4867
  • Fax: 402-489-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number261
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: