MEDICARE: CORY ANN SWANN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	34008784A	IN

General Provider Information

NPI Number	:	1255942843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORY ANN SWANN LCSW

Provider Business Mailing Address
First Line	:	1130 LONDONERRY LN
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46142-1632
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 LONDONERRY LN
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46142-1632
Country	:	US
Telephone Number	:	812-568-5267
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2020
Last Update Date	:	09/18/2023

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