Provider Demographics
NPI:1104437029
Name:SWINTON, SHAKELA LANESHA (LMHC)
Entity type:Individual
Prefix:
First Name:SHAKELA
Middle Name:LANESHA
Last Name:SWINTON
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 1:3023 BIGELOW DR
Mailing Address - Street 2:
Mailing Address - City:HOLIDAY
Mailing Address - State:FL
Mailing Address - Zip Code:34691-3172
Mailing Address - Country:US
Mailing Address - Phone:727-643-3376
Mailing Address - Fax:
Practice Address - Street 1:3023 BIGELOW DR
Practice Address - Street 2:
Practice Address - City:HOLIDAY
Practice Address - State:FL
Practice Address - Zip Code:34691-3172
Practice Address - Country:US
Practice Address - Phone:727-643-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health