Provider Demographics
NPI:1255496345
Name:SWAN, MARGARET DEPUY (MA LPC LMFT LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:DEPUY
Last Name:SWAN
Suffix:
Gender:F
Credentials:MA LPC LMFT LCPC
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 708
Mailing Address - Street 2:ACCOMAC
Mailing Address - City:ACCOMAC
Mailing Address - State:VA
Mailing Address - Zip Code:23301
Mailing Address - Country:US
Mailing Address - Phone:757-787-9155
Mailing Address - Fax:757-787-9156
Practice Address - Street 1:23613 FRONT ST
Practice Address - Street 2:ACCOMAC FAMILY COUNSELING
Practice Address - City:ACCOMAC
Practice Address - State:VA
Practice Address - Zip Code:23301
Practice Address - Country:US
Practice Address - Phone:757-787-9155
Practice Address - Fax:757-787-9156
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002318101YP2500X
MDLC0230101YP2500X
VA0717000393106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
288490OtherANTHEM
540156OtherMAMSI
024656OtherTRICARE VALUE OPTIONS