JACYNTHIA SWANN


Address: 405 Morson St Ste A, Raleigh, NC 27601-1559
Phone: 9196072044

JACYNTHIA SWANN (NPI# 1447529466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447529466
Entity Type Individual
Full Name JACYNTHIA SWANN
Practice Address 405 Morson St Ste A
Raleigh
NC 27601-1559
Practice Telephone 9196072044
Mailing Telephone 9196072044
Enumeration Date 2011-12-20
Last Update Date 2011-12-20
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TM1800X Psychologist
Specialization: Mental Retardation & Developmental Disabilities
NC Behavioral Health & Social Service Providers
N 172V00000X Community Health Worker NC Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC 900780474 05

Office Location

Street Address 405 MORSON ST STE A
City RALEIGH
State NC
Zip Code 27601-1559

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Taxonomy Information

Taxonomy Code 103TM1800X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Mental Retardation & Developmental Disabilities

Taxonomy Definition

Definition to come...

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Competitor

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City RALEIGH
Zip Code 27601

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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