Healthcare Provider Details

I. General information

NPI: 1962970905
Provider Name (Legal Business Name): ABIGAIL SWIGER LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 02/14/2024
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 BRIDGE AVE
CLEVELAND OH
44113-3304
US

IV. Provider business mailing address

1370 SLOANE AVE APT 801
LAKEWOOD OH
44107-3160
US

V. Phone/Fax

Practice location:
  • Phone: 216-631-5800
  • Fax: 216-631-4595
Mailing address:
  • Phone: 513-335-8048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1901630-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: