Basic Information
Provider Information
NPI: 1619090685
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PINTO-SWIFT
FirstName: BONNIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SWIFT
OtherFirstName: BONNIE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: LICSW
OtherLastNameType: 5
Mailing Information
Address1: 121 MOULTON ST
Address2:  
City: WEST NEWBURY
State: MA
PostalCode: 019852212
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 100 LEDGEWOOD PL
Address2: SUITE 202
City: ROCKLAND
State: MA
PostalCode: 023701075
CountryCode: US
TelephoneNumber: 7818716550
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/06/2007
LastUpdateDate: 06/23/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X1016610MAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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