Provider Demographics
NPI:1578941837
Name:SWAILS, JOHN MARTIN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MARTIN
Last Name:SWAILS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 OLD STAGECOACH LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-8234
Mailing Address - Country:US
Mailing Address - Phone:919-377-0099
Mailing Address - Fax:844-857-0857
Practice Address - Street 1:2800 OLD STAGECOACH LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-8234
Practice Address - Country:US
Practice Address - Phone:919-377-0099
Practice Address - Fax:844-856-0856
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1948106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty