Provider Demographics
NPI:1689978413
Name:SWANSON, SYBILLE LORE (MSC)
Entity Type:Individual
Prefix:MRS
First Name:SYBILLE
Middle Name:LORE
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13378 POINT RIDER LANE
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171
Mailing Address - Country:US
Mailing Address - Phone:703-437-7911
Mailing Address - Fax:
Practice Address - Street 1:6 PIDGEON HILL DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165
Practice Address - Country:US
Practice Address - Phone:703-433-5771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor