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General NPI Number Information
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NPI Number | 1104169341
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Entity Type | Individual
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Provider Name | MONICA A. SWAYNE LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/05/2013
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 640 PLUM STREET SUITE 205
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City | MACON
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State | GA
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Zip | 31201-2859
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Country | US
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Telephone | 888-561-5568
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Fax | 877-389-1333
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Provider Business Mailing Address
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Address Line | PO BOX 6643
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City | MACON
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State | GA
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Zip | 31208-6643
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Country | US
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Telephone | 888-561-5688
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Fax | 877-389-1333
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW004790
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License Number State | GA
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