Healthcare Provider Details

I. General information

NPI: 1063582377
Provider Name (Legal Business Name): MARY SWOBODA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY FRANCES SWOBODA LCSW, LMHP

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 10/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 UNION DR SUITE 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: 402-450-3614
  • Fax: 402-489-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number277
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number717
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: