Provider Demographics
NPI:1689713786
Name:SWICK, CAROLYN M (LMHC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:SWICK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 LONG POND RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2662
Mailing Address - Country:US
Mailing Address - Phone:508-747-6762
Mailing Address - Fax:
Practice Address - Street 1:118 LONG POND RD
Practice Address - Street 2:SUITE 106
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2662
Practice Address - Country:US
Practice Address - Phone:508-747-6762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7944101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health