| Cornelia Swayze, Lcsw, Llc | |
|
4423 Leisure Time Dr Diamondhead MS 39525-3221 | |
| (228) 363-2211 | |
| (228) 255-6494 |
| Full Name | Cornelia Swayze, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4423 Leisure Time Dr, Diamondhead, Mississippi |
| Authorized Official Name and Position | Cornelia Swayze (OWNER) |
| Authorized Official Contact | 2283632211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornelia Swayze, Lcsw, Llc 7619 Fairway Dr Diamondhead MS 39525-3436 Ph: (228) 363-2211 | Cornelia Swayze, Lcsw, Llc 4423 Leisure Time Dr Diamondhead MS 39525-3221 Ph: (228) 363-2211 |
| NPI Number | 1235449273 |
|---|---|
| Provider Enumeration Date | 10/08/2010 |
| Last Update Date | 10/08/2010 |
| Medicare PECOS PAC ID | 3173716297 |
|---|---|
| Medicare Enrollment ID | O20101021000990 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235449273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | C4648 (Mississippi) | Primary |
| Provider Name | Cornelia Swayze |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356445944 PECOS PAC ID: 5698795755 Enrollment ID: I20051205000109 |
Chamberlain Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 79321 Diamondhead Dr E, Diamondhead, MS 39525 Phone: 601-850-8663 | |
Mary R. Stock, Phd, Lcsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4423 Leisure Time Dr, Diamondhead, MS 39525 Phone: 228-216-0130 |