Provider Demographics
NPI:1669649232
Name:ADRIENNE SWIFT PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:ADRIENNE SWIFT PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SWIFT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:513-860-2313
Mailing Address - Street 1:4220 TYLERS ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-8533
Mailing Address - Country:US
Mailing Address - Phone:513-860-2313
Mailing Address - Fax:513-860-4192
Practice Address - Street 1:8080 BECKETT CENTER DR
Practice Address - Street 2:SUITE 313
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5026
Practice Address - Country:US
Practice Address - Phone:513-860-2313
Practice Address - Fax:513-860-4192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6031103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00399852OtherRAILROAD MEDICARE PTAN
OH2641949Medicaid
OHSWCP30082Medicare PIN