Provider Demographics
NPI:1437206364
Name:SWEIGART, JAMES RUSSEL (MA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RUSSEL
Last Name:SWEIGART
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6853 HEATHERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9230
Mailing Address - Country:US
Mailing Address - Phone:734-429-7266
Mailing Address - Fax:
Practice Address - Street 1:403 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2127
Practice Address - Country:US
Practice Address - Phone:517-266-8500
Practice Address - Fax:866-223-1175
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401004601101YM0800X
MI6301007352103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist