Provider Demographics
NPI:1790491702
Name:MCSWAIN, LARRY C (LICENSED COUNSELOR)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:C
Last Name:MCSWAIN
Suffix:
Gender:M
Credentials:LICENSED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1853 ARBORETUM CIR APT D
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-3132
Mailing Address - Country:US
Mailing Address - Phone:205-386-0310
Mailing Address - Fax:
Practice Address - Street 1:1853 ARBORETUM CIR APT D
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-3132
Practice Address - Country:US
Practice Address - Phone:251-767-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC04360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty