Provider Demographics
NPI:1124009899
Name:SWOPE, RICHARD R (MED, MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:R
Last Name:SWOPE
Suffix:
Gender:M
Credentials:MED, MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4260
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302
Mailing Address - Country:US
Mailing Address - Phone:503-269-3593
Mailing Address - Fax:
Practice Address - Street 1:1193 ROYVONNE AVE SE
Practice Address - Street 2:SUITE #23
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-6500
Practice Address - Country:US
Practice Address - Phone:503-269-3593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health