Provider Demographics
NPI:1881016152
Name:SWINDALL, LAMONT
Entity Type:Individual
Prefix:
First Name:LAMONT
Middle Name:
Last Name:SWINDALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N LOTTIE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-2000
Mailing Address - Country:US
Mailing Address - Phone:405-476-1150
Mailing Address - Fax:
Practice Address - Street 1:1300 N LOTTIE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-2000
Practice Address - Country:US
Practice Address - Phone:405-476-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health