| Swn Therapy Llc | |
|
3001 Fuller Ave Ne Ste 1 Grand Rapids MI 49505-3204 | |
| (616) 426-2328 | |
| Not Available |
| Full Name | Swn Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3001 Fuller Ave Ne Ste 1, Grand Rapids, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Swn Therapy Llc Po Box 10 Mason MI 48854-0010 Ph: () - | Swn Therapy Llc 3001 Fuller Ave Ne Ste 1 Grand Rapids MI 49505-3204 Ph: (616) 426-2328 |
| NPI Number | 1124665484 |
|---|---|
| Provider Enumeration Date | 12/05/2019 |
| Last Update Date | 04/11/2024 |
| Certification Date | 04/11/2024 |
| Medicare PECOS PAC ID | 1658706387 |
|---|---|
| Medicare Enrollment ID | O20200127000968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124665484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Stacey Dawn Williamson Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508945577 PECOS PAC ID: 7214089119 Enrollment ID: I20090723000017 |
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