MEDICARE: MRS. CHARLOTTE MCCAFFERTY SWENSON PHD

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	103T00000X	Psychologist	B1-0000190	DE
2	103T00000X	Psychologist	PS-0042726	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	62006383	OTHER	DE	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1878454	OTHER	DE	FIRST HEALTH
2	PVPB43922	OTHER	DE	APS
3	233395	OTHER	DE	COMPSYCH

General Provider Information

NPI Number	:	1811998347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHARLOTTE MCCAFFERTY SWENSON PHD

Provider Business Mailing Address
First Line	:	3411 SILVERSIDE RD
Second Line	:	WELDIN BLDG - 109
City	:	WILMINGTON
State	:	DE
Zip	:	19810-4812
Country	:	US
Telephone Number	:	302-743-3843
Fax Number	:	302-529-5763

Provider Business Practice Location Address
First Line	:	3411 SILVERSIDE RD
Second Line	:	WELDIN BLDG - 109
City	:	WILMINGTON
State	:	DE
Zip	:	19810-4812
Country	:	US
Telephone Number	:	302-743-3843
Fax Number	:	302-529-5763

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	08/31/2015

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Directions to “ MRS. CHARLOTTE MCCAFFERTY SWENSON PHD” Practice Location

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