Provider Demographics
NPI:1114948700
Name:SWINK, KATHY K (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:K
Last Name:SWINK
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 MINISTERIAL RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-1317
Mailing Address - Country:US
Mailing Address - Phone:401-783-0960
Mailing Address - Fax:401-789-5560
Practice Address - Street 1:1980 MINISTERIAL RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-1317
Practice Address - Country:US
Practice Address - Phone:401-783-0960
Practice Address - Fax:401-789-5560
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00045101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI410439OtherBLUE CHIP
RI1023380OtherBEACON HEALTH
RI6271198OtherUNITED BEH. HEALTH
RI7167-1OtherBCBSRI