Provider Demographics
NPI:1306908389
Name:SWYERS, JOHN (MHR, LPC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SWYERS
Suffix:
Gender:M
Credentials:MHR, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6709 E 75TH CT
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3031
Mailing Address - Country:US
Mailing Address - Phone:918-413-6974
Mailing Address - Fax:
Practice Address - Street 1:7291 E 81ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4228
Practice Address - Country:US
Practice Address - Phone:918-413-6974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4160101YP2500X
OK14112101YP2500X
AK671101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional