Individual
AMY L SWAIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5613 DURALEIGH RD, SUITE 161, RALEIGH, NC 27612-2694
(919) 830-2072
Mailing address
716 WINDING OAK WAY, CLAYTON, NC 27520-7129
(919) 830-2072
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004130
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061677882
FEDERAL TAX
NC
01
—
131EX
BCBS PROVIDER NUMBER
NC
05
—
6002437
—
NC
Enumeration date
12/26/2006
Last updated
05/20/2012
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