Provider Demographics
NPI:1801304191
Name:SWIFT, JOHN PATRICK (LPCMH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:SWIFT
Suffix:
Gender:M
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 W REDMONT RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3713
Mailing Address - Country:US
Mailing Address - Phone:302-887-6753
Mailing Address - Fax:
Practice Address - Street 1:1601 MILLTOWN RD STE 1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4047
Practice Address - Country:US
Practice Address - Phone:302-660-9478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-20
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000840101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health