Provider Demographics
NPI:1154466225
Name:SWAIN, JOHN B (LMHC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:SWAIN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 SKYLINE WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2992
Mailing Address - Country:US
Mailing Address - Phone:360-873-8662
Mailing Address - Fax:207-433-1133
Practice Address - Street 1:1909 SKYLINE WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2992
Practice Address - Country:US
Practice Address - Phone:360-873-8662
Practice Address - Fax:207-433-1133
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1087101YM0800X
WALH60229163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432503699Medicaid