Provider Demographics
NPI:1407269376
Name:SWARTZ, RYAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:SWARTZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 OLD GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-6600
Mailing Address - Country:US
Mailing Address - Phone:770-877-0795
Mailing Address - Fax:
Practice Address - Street 1:1435 OLD GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-6600
Practice Address - Country:US
Practice Address - Phone:770-877-0795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-08
Last Update Date:2014-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 007789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional