Provider Demographics
NPI:1265456867
Name:SWAFFORD, KAY GIRVIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAY
Middle Name:GIRVIN
Last Name:SWAFFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATY
Other - Middle Name:G
Other - Last Name:SWAFFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3355 BEE CAVE RD
Mailing Address - Street 2:BUILDING 1, SUITE 104
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6775
Mailing Address - Country:US
Mailing Address - Phone:512-328-8820
Mailing Address - Fax:512-322-0897
Practice Address - Street 1:3355 BEE CAVE RD
Practice Address - Street 2:BUILDING 1, SUITE 104
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6775
Practice Address - Country:US
Practice Address - Phone:512-328-8820
Practice Address - Fax:512-322-0897
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-4745103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX680014809OtherRR MCARE 635R
TX83346POtherBCBS 635R
TX100336004Medicaid
TX83151POtherBCBS 632R
TX680014100OtherRR MCARE 632R
TX100336005Medicaid
TX83346POtherBCBS 635R
TX83151PMedicare ID - Type UnspecifiedMCARE 632R
TX100336004Medicaid