Provider Demographics
NPI:1033920103
Name:SWANN, GHALYSA CHARA LERA (MFTI)
Entity type:Individual
Prefix:DR
First Name:GHALYSA
Middle Name:CHARA LERA
Last Name:SWANN
Suffix:
Gender:
Credentials:MFTI
Other - Prefix:DR
Other - First Name:GHALYSA
Other - Middle Name:CHARA LERA
Other - Last Name:SWANN-WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFTI
Mailing Address - Street 1:1101 W 40TH ST UNIT 2225
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37409-1379
Mailing Address - Country:US
Mailing Address - Phone:877-358-2998
Mailing Address - Fax:
Practice Address - Street 1:7 N TUXEDO AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-3728
Practice Address - Country:US
Practice Address - Phone:877-358-2998
Practice Address - Fax:423-405-6346
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional