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General NPI Number Information
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NPI Number | 1558869545
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Entity Type | Individual
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Provider Name | LEAH C SWENSON
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Gender | Female
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 02/08/2020
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Provider Practice Location Address
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Address Line | 2120 S MCCLINTOCK DR STE 105
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City | TEMPE
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State | AZ
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Zip | 85282-2692
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Country | US
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Telephone | 480-804-0326
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Fax | 480-804-0083
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Provider Business Mailing Address
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Address Line | 650 E INDIAN SCHOOL RD BLDG 23
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City | PHOENIX
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State | AZ
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Zip | 85012-1839
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Country | US
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Telephone | 602-277-5551
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW14020
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-18331
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License Number State | AZ
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