Active NPI
Sally Jean Swan, L-MSW
- Social Worker
- Center Moriches, NY
National Provider Identifier
1174712343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 066399-1
- Practice address
- 220 Main St
Center Moriches, NY 11934-3504 - Phone
- (631) 874-2700
- NPI assigned
- Oct 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 066399-1 | NY | Primary |
Addresses
Primary practice location
220 Main St
Center Moriches, NY 11934-3504
Mailing address
102 Crystal Beach Blvd
Moriches, NY 11955-1907
Phone (631) 874-1006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 066399-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193097600000",
"number": "1174712343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 CRYSTAL BEACH BLVD",
"city": "MORICHES",
"state": "NY",
"postal_code": "119551907",
"telephone_number": "631-874-1006",
"fax_number": "631-874-4777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 MAIN ST",
"city": "CENTER MORICHES",
"state": "NY",
"postal_code": "119343504",
"telephone_number": "631-874-2700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAN",
"first_name": "SALLY",
"middle_name": "JEAN",
"credential": "L-MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-23",
"last_updated": "2007-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "066399-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Center Moriches, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.