Provider Demographics
NPI:1003965526
Name:SWIFT, GREGORY (LMFT)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:SWIFT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 EARLHAM STREET #1
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1273
Mailing Address - Country:US
Mailing Address - Phone:626-394-6797
Mailing Address - Fax:
Practice Address - Street 1:1151 6TH STREET
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1828
Practice Address - Country:US
Practice Address - Phone:213-639-2562
Practice Address - Fax:213-385-9246
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36825106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist