Provider Demographics
NPI:1700306552
Name:SWAGGER, REBECCA (MA, MA, LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SWAGGER
Suffix:
Gender:F
Credentials:MA, MA, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 158
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06247
Mailing Address - Country:US
Mailing Address - Phone:860-377-0387
Mailing Address - Fax:401-681-4285
Practice Address - Street 1:227 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06247
Practice Address - Country:US
Practice Address - Phone:860-377-0387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00873101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health