Provider Demographics
NPI:1235451055
Name:MAYER-SWIFT, SARAH ANN (LPCC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:MAYER-SWIFT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:MAYER-SWIFT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC
Mailing Address - Street 1:2551 COORS BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2503 RIDGE RUNNER RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4972
Practice Address - Country:US
Practice Address - Phone:505-454-8265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0107661101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional