Healthcare Provider Details

I. General information

NPI: 1689805376
Provider Name (Legal Business Name): BARBARA SCOTT SWIMMER LISW-S, LCDCIII, SAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14650 DETROIT AVENUE SUITE LL40
LAKEWOOD OH
44107
US

IV. Provider business mailing address

14650 DETROIT AVENUE SUITE LL40
LAKEWOOD OH
44107
US

V. Phone/Fax

Practice location:
  • Phone: 216-226-2721
  • Fax: 216-226-2731
Mailing address:
  • Phone: 216-226-2721
  • Fax: 216-226-2731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number071029
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI. 0031096
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0031096
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: