Provider Demographics
NPI:1396048294
Name:SWANZEY, KATHY BROWNING (LCSW, LCAS)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:BROWNING
Last Name:SWANZEY
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 FRIENDSHIP PATTERSON MILL RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9619
Mailing Address - Country:US
Mailing Address - Phone:910-935-0038
Mailing Address - Fax:910-399-6598
Practice Address - Street 1:3725 WRIGHTSVILLE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4140
Practice Address - Country:US
Practice Address - Phone:910-251-7789
Practice Address - Fax:910-399-6598
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-15
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1737101YA0400X
NCC0076891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6112211Medicaid
NCQ39549AMedicare PIN