Provider Demographics
NPI:1689325680
Name:SWIFT, STEPHANIE (LMFTA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HAWLEY TER
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-3820
Mailing Address - Country:US
Mailing Address - Phone:203-312-6958
Mailing Address - Fax:
Practice Address - Street 1:8 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NIANTIC
Practice Address - State:CT
Practice Address - Zip Code:06357-2303
Practice Address - Country:US
Practice Address - Phone:203-312-6958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2794106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist