Provider Demographics
NPI:1356182620
Name:SWANSON, JULIE ANN (LMSW)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:SWANSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2195 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2705
Mailing Address - Country:US
Mailing Address - Phone:563-324-9169
Mailing Address - Fax:563-324-2437
Practice Address - Street 1:1320 19TH AVE NW
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2752
Practice Address - Country:US
Practice Address - Phone:563-243-5633
Practice Address - Fax:563-243-9567
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007099104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker