1922109131 NPI number — MRS. FLORA LOU SWEARINGEN LCSW

Table of content: MRS. FLORA LOU SWEARINGEN LCSW (NPI 1922109131)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922109131 NPI number — MRS. FLORA LOU SWEARINGEN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWEARINGEN
Provider First Name:
FLORA
Provider Middle Name:
LOU
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WRIGHT
Provider Other First Name:
FLORA
Provider Other Middle Name:
LOU
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1922109131
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 E RANDOLPH ST
Provider Second Line Business Mailing Address:
SUITE 2209
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60601-5035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-565-0825
Provider Business Mailing Address Fax Number:
312-565-0825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 N MICHIGAN AVE
Provider Second Line Business Practice Location Address:
SUITE 629
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60601-5035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-729-5157
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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