Healthcare Provider Details

I. General information

NPI: 1427969492
Provider Name (Legal Business Name): ANDREA LYNN SWALLOW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1526 ATWOOD AVE STE 104
JOHNSTON RI
02919-3289
US

IV. Provider business mailing address

3 MAPLE AVE
SMITHFIELD RI
02917-3642
US

V. Phone/Fax

Practice location:
  • Phone: 401-246-7090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number012627
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number04548
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: