Provider Demographics
NPI:1548483530
Name:SWIFT, SONCEREA TRILL (FP)
Entity type:Individual
Prefix:
First Name:SONCEREA
Middle Name:TRILL
Last Name:SWIFT
Suffix:
Gender:F
Credentials:FP
Other - Prefix:
Other - First Name:SONCERIA
Other - Middle Name:
Other - Last Name:SWIFT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FP
Mailing Address - Street 1:9737 W RUNION DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2289
Mailing Address - Country:US
Mailing Address - Phone:480-669-7151
Mailing Address - Fax:
Practice Address - Street 1:4521 W MAGDALENA LN
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-2351
Practice Address - Country:US
Practice Address - Phone:480-709-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2022-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
AZ11066104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ101552Medicaid