Provider Demographics
NPI:1902338577
Name:SWAFFORD, DEANNA (LPCC)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-9752
Mailing Address - Country:US
Mailing Address - Phone:606-224-6897
Mailing Address - Fax:
Practice Address - Street 1:1916 MALLARD DR
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-9752
Practice Address - Country:US
Practice Address - Phone:606-224-6897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-01
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY104617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional