Provider Demographics
NPI:1780963157
Name:SWINFORD, DEBORA KAY (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:KAY
Last Name:SWINFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 W COUNTY ROAD 1400 N
Mailing Address - Street 2:
Mailing Address - City:CARBON
Mailing Address - State:IN
Mailing Address - Zip Code:47837-8029
Mailing Address - Country:US
Mailing Address - Phone:765-720-2505
Mailing Address - Fax:
Practice Address - Street 1:599 W COUNTY ROAD 1400 N
Practice Address - Street 2:
Practice Address - City:CARBON
Practice Address - State:IN
Practice Address - Zip Code:47837-8029
Practice Address - Country:US
Practice Address - Phone:765-720-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000992A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical