Provider Demographics
NPI:1417041542
Name:SWEIGART, SUSAN JUDITH (MS LPCC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JUDITH
Last Name:SWEIGART
Suffix:
Gender:F
Credentials:MS LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 W WENGER RD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2754
Mailing Address - Country:US
Mailing Address - Phone:937-826-8478
Mailing Address - Fax:937-836-4799
Practice Address - Street 1:12 W WENGER RD
Practice Address - Street 2:SUITE B-1
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2754
Practice Address - Country:US
Practice Address - Phone:937-836-4788
Practice Address - Fax:937-836-4799
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
7018611OtherAETNA
720484000OtherMAGELLAN
000000337819OtherBLUE CROSS BLUE SHIELD
349496OtherMHN