Provider Demographics
NPI:1467760835
Name:SWAN, CYNTHIA (LPC, LCPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:SWAN
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 RIDGE RD UNIT L
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2967
Mailing Address - Country:US
Mailing Address - Phone:303-437-7505
Mailing Address - Fax:
Practice Address - Street 1:18 RIDGE RD UNIT L
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2967
Practice Address - Country:US
Practice Address - Phone:303-437-7505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6402101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional