Provider Demographics
NPI:1518378280
Name:SWEARINGEN, STEPHEN (LMHC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SWEARINGEN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6045 NE 35TH PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-7358
Mailing Address - Country:US
Mailing Address - Phone:503-464-6766
Mailing Address - Fax:
Practice Address - Street 1:1101 BROADWAY ST STE 230
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3320
Practice Address - Country:US
Practice Address - Phone:360-719-2852
Practice Address - Fax:888-808-8143
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60441313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health