Provider Demographics
NPI:1306927769
Name:SWAIM, KEVIN CLAY (MA,LMFT,LCSW,LMHC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:CLAY
Last Name:SWAIM
Suffix:
Gender:M
Credentials:MA,LMFT,LCSW,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 E STOP 11 RD STE 14
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8629
Mailing Address - Country:US
Mailing Address - Phone:317-409-3128
Mailing Address - Fax:317-889-4499
Practice Address - Street 1:5150 E STOP 11 RD STE 14
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8629
Practice Address - Country:US
Practice Address - Phone:317-409-3128
Practice Address - Fax:317-889-4499
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000420A101YM0800X
IN34002741A1041C0700X
IN35000135A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN34002741AOtherLCSW LICENSE
IN35000135AOtherLMFT LICENSE
IN39000420AOtherLMHC LICENSE