Provider Demographics
NPI:1386265049
Name:SWANSON, LAURA EMILY (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:EMILY
Last Name:SWANSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 MAIN ST APT 7
Mailing Address - Street 2:
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-1680
Mailing Address - Country:US
Mailing Address - Phone:716-720-1637
Mailing Address - Fax:
Practice Address - Street 1:176 MAIN ST
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-1696
Practice Address - Country:US
Practice Address - Phone:716-720-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0977281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical