Shane Miles Swoverland, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008679A Issued in IN

Practice address

2500 E State Blvd
Fort Wayne, IN 46805-4728

Phone

(260) 426-5431

Fax

(260) 460-1481

NPI assigned

Jan 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1952931594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054728",
            "telephone_number": "260-426-5431",
            "fax_number": "260-460-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054728",
            "telephone_number": "260-426-5431",
            "fax_number": "260-460-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWOVERLAND",
        "first_name": "SHANE",
        "middle_name": "MILES",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008679A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Thomas Swinehart
• Kalyca Swinford
• Andrew Swing
• Robert E. Swint Sr., MD
• Kristie L Swoverland, PT
• Trenton R Swoverland, P.T.
• Brittany Swygart, PT, DPT, CSRS
• Brittany Audra Swygart
• Rebecca Marie Swygart
• Sycamore Hills Dentistry

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.