MEDICARE: MRS. MICHELLE A SWABIK LMFT

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	106H00000X	Marriage & Family Therapist	002360-01	NY
2	106H00000X	Marriage & Family Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	002360-01	OTHER	NY	NYS LICENSE

General Provider Information

NPI Number	:	1578275244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE A SWABIK LMFT

Provider Business Mailing Address
First Line	:	191 PARK ST
Second Line	:
City	:	SHERMAN
State	:	NY
Zip	:	14781-9624
Country	:	US
Telephone Number	:	716-753-6977
Fax Number	:

Provider Business Practice Location Address
First Line	:	1465 FOOTE AVENUE EXT
Second Line	:
City	:	JAMESTOWN
State	:	NY
Zip	:	14701-9383
Country	:	US
Telephone Number	:	716-526-4041
Fax Number	:

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

Provider Enumeration Date	:	12/14/2022
Last Update Date	:	06/05/2025

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