Cornelia Swayze, LCSW, LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

C4648 Issued in MS

Legal business name

CORNELIA SWAYZE, LCSW, LLC

Practice address

4423 Leisure Time Dr
Diamondhead, MS 39525-3221

Phone

(228) 363-2211

Fax

(228) 255-6494

NPI assigned

Oct 8, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cornelia Swayze, LCSWNPI 1356445944

Title

Owner

Phone

(228) 363-2211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cornelia H. Swayze, LCSW, BCD

  • Clinical Social Worker
  • Diamondhead, MS
  • NPI 1356445944

  MS

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286496000000",
    "number": "1235449273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 FAIRWAY DR",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253436",
            "telephone_number": "228-363-2211",
            "fax_number": "228-255-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 LEISURE TIME DR",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "395253221",
            "telephone_number": "228-363-2211",
            "fax_number": "228-255-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELIA SWAYZE, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-08",
        "last_updated": "2010-10-08",
        "status": "A",
        "authorized_official_last_name": "SWAYZE",
        "authorized_official_first_name": "CORNELIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-363-2211",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MS",
            "license": "C4648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Diamondhead, MS
• Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.