Provider Demographics
NPI:1528357167
Name:SWEDLAW, HENRY J (LMHC)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:J
Last Name:SWEDLAW
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 HIBISCUS DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4554
Mailing Address - Country:US
Mailing Address - Phone:561-703-8297
Mailing Address - Fax:
Practice Address - Street 1:1150 HIBISCUS DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-4554
Practice Address - Country:US
Practice Address - Phone:561-703-8297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health