Provider Demographics
NPI:1881132918
Name:SWARTWOUT, SANDRA LEE (LMHC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE
Last Name:SWARTWOUT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 THERESA CT
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4715
Mailing Address - Country:US
Mailing Address - Phone:716-275-2543
Mailing Address - Fax:
Practice Address - Street 1:95 THERESA CT
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-4715
Practice Address - Country:US
Practice Address - Phone:716-547-1874
Practice Address - Fax:716-608-1512
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010616101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010616OtherMENTAL HEALTH COUNSELING LICENSE