MEDICARE: KIMBERLY K SWIECKI MSW, LISW

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	I1800846	OH

General Provider Information

NPI Number	:	1548734320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY K SWIECKI MSW, LISW

Provider Business Mailing Address
First Line	:	237 WILLIAM HOWARD TAFT RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2610
Country	:	US
Telephone Number	:	877-651-4343
Fax Number	:	513-366-4491

Provider Business Practice Location Address
First Line	:	4803 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-1152
Country	:	US
Telephone Number	:	513-631-2474
Fax Number	:	513-531-0862

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

Provider Enumeration Date	:	01/15/2019
Last Update Date	:	02/19/2019

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