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General NPI Number Information
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NPI Number | 1811048002
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Entity Type | Individual
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Provider Name | JONATHAN WETHERBY SWIFT L.C.S.W., PH.D
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Gender | Male
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 588 BOSTON POST RD SUITE EAST
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City | MADISON
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State | CT
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Zip | 06443-3042
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Country | US
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Telephone | 203-245-0062
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Fax | 203-245-9446
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Provider Business Mailing Address
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Address Line | 588 BOSTON POST RD SUITE EAST
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City | MADISON
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State | CT
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Zip | 06443-3042
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Country | US
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Telephone | 203-245-0062
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Fax | 203-245-9446
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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 | 1821
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License Number State | CT
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