Provider Demographics
NPI:1184943904
Name:KOVACH, CHRISTINE SWARTWOUT (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SWARTWOUT
Last Name:KOVACH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 ENCINAL AVE
Mailing Address - Street 2:STE. K
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4889
Mailing Address - Country:US
Mailing Address - Phone:510-364-3723
Mailing Address - Fax:
Practice Address - Street 1:3215 ENCINAL AVE
Practice Address - Street 2:STE. K
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4889
Practice Address - Country:US
Practice Address - Phone:510-364-3723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS202741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical