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General NPI Number Information
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NPI Number | 1114392453
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Entity Type | Organization
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Legal Business Name | RISA SWELL, LCSW, CEAP, LLC
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Dates
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Enumeration Date | 12/12/2015
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Last Update Date | 12/12/2015
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Provider Practice Location Address
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Address Line | 2301 E EVESHAM RD STE 109
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City | VOORHEES
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State | NJ
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Zip | 08043-4502
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Country | US
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Telephone | 856-905-2303
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Fax |
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Provider Business Mailing Address
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Address Line | 9 COLLAGE LN
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City | CHERRY HILL
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State | NJ
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Zip | 08003-5108
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Country | US
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Telephone | 856-905-2303
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RISA SWELL
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Credential | LCSW, CEAP
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Telephone | 856-905-2303
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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 | 44SC00868400
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License Number State | NJ
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