Provider Demographics
NPI:1013761295
Name:SWIGART, TERA LYN (LMSW)
Entity type:Individual
Prefix:
First Name:TERA
Middle Name:LYN
Last Name:SWIGART
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18330 BLANCHMONT LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3427
Mailing Address - Country:US
Mailing Address - Phone:832-423-3126
Mailing Address - Fax:
Practice Address - Street 1:18330 BLANCHMONT LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3427
Practice Address - Country:US
Practice Address - Phone:832-423-3126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108641104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker