Provider Demographics
NPI:1831886811
Name:SWIFT, CARLENE (PHD)
Entity type:Individual
Prefix:DR
First Name:CARLENE
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 W GREEN OAKS BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-2793
Mailing Address - Country:US
Mailing Address - Phone:682-305-2123
Mailing Address - Fax:
Practice Address - Street 1:3939 W GREEN OAKS BLVD STE 204
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-2793
Practice Address - Country:US
Practice Address - Phone:682-305-2123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39444103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical