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General NPI Number Information
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NPI Number | 1982636981
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Entity Type | Individual
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Provider Name | ILENE SWARTZ MSW LICSW
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 583 CHESTNUT ST SUITE 12
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City | LYNN
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State | MA
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Zip | 01904-2600
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Country | US
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Telephone | 617-797-6528
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Fax | 781-477-3930
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Provider Business Mailing Address
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Address Line | 24 ALLEN AVE
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City | LYNN
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State | MA
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Zip | 01902-2735
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Country | US
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Telephone | 617-797-6528
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Fax | 781-477-3930
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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 | 1016635
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License Number State | MA
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