Provider Demographics
NPI:1205868700
Name:MEFFORD, PAUL SWIFT (LCSW)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:SWIFT
Last Name:MEFFORD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 MAXWELL AVENUE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711
Mailing Address - Country:US
Mailing Address - Phone:812-422-7974
Mailing Address - Fax:812-422-8163
Practice Address - Street 1:2015 MAXWELL AVENUE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711
Practice Address - Country:US
Practice Address - Phone:812-422-7974
Practice Address - Fax:812-671-0627
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002114A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
216940Medicare PIN