Provider Demographics
NPI:1093066391
Name:SWILLEY, MARSHA ANN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:ANN
Last Name:SWILLEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 EDUCATION WAY
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-6041
Mailing Address - Country:US
Mailing Address - Phone:410-526-4888
Mailing Address - Fax:
Practice Address - Street 1:520 EDUCATION WAY
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-6041
Practice Address - Country:US
Practice Address - Phone:410-526-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional