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General NPI Number Information
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NPI Number | 1558988394
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Entity Type | Individual
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Provider Name | MARY BIBB SWIMS
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Gender | Female
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Dates
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Enumeration Date | 06/27/2020
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 1030 KINGS HWY N STE 202
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City | CHERRY HILL
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State | NJ
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Zip | 08034-1907
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Country | US
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Telephone | 201-820-0057
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | 240 RENAISSANCE PKWY NE APT 113
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City | ATLANTA
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State | GA
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Zip | 30308-2349
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Country | US
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Telephone | 845-706-3221
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW006951
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License Number State | GA
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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 | 44SC05999800
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License Number State | NJ
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