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NPI 1609892405

NPI 1609892405 : GARY MICHAEL SWARGA LMSW : PONTIAC, MI

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General NPI Number Information
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    NPI Number           |    1609892405
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    Entity Type          |    Individual 
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    Provider Name        |    GARY MICHAEL SWARGA LMSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/14/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    114 ORCHARD LAKE RD 
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    City                 |    PONTIAC
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    State                |    MI
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    Zip                  |    48341-2244
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    Country              |    US
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    Telephone            |    248-858-7766
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    Fax                  |    248-858-7201
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2241 
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    City                 |    SOUTHFIELD
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    State                |    MI
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    Zip                  |    48037-2241
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    Country              |    US
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    Telephone            |    248-352-4380
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    Fax                  |    248-858-7201
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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       |    6801084372
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    License Number State |    MI
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