Provider Demographics
NPI:1881138972
Name:SWOPE, LAURIE GORDON (LPC, RPT, CPCS)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:GORDON
Last Name:SWOPE
Suffix:
Gender:F
Credentials:LPC, RPT, CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 WHITESTONE WAY
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4181
Mailing Address - Country:US
Mailing Address - Phone:678-772-9988
Mailing Address - Fax:
Practice Address - Street 1:1505 LAKES PKWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5890
Practice Address - Country:US
Practice Address - Phone:678-772-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010109101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1881138972Medicaid