MEDICARE: MRS. KATHY S. SWIFT 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	CW006233L	PA

General Provider Information

NPI Number	:	1821165028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHY S. SWIFT LCSW

Provider Business Mailing Address
First Line	:	815 GRANDVIEW RD
Second Line	:	P.O. BOX 886
City	:	OIL CITY
State	:	PA
Zip	:	16301-2077
Country	:	US
Telephone Number	:	814-676-5614
Fax Number	:	814-677-5760

Provider Business Practice Location Address
First Line	:	815 GRANDVIEW RD
Second Line	:
City	:	OIL CITY
State	:	PA
Zip	:	16301-2077
Country	:	US
Telephone Number	:	814-676-5614
Fax Number	:	814-677-5760

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

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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