Provider Demographics
NPI:1588451462
Name:SWINGLE, LAURA GRACE (LMHP-R)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:GRACE
Last Name:SWINGLE
Suffix:
Gender:
Credentials:LMHP-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 PETERS CREEK RD NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24017-1621
Mailing Address - Country:US
Mailing Address - Phone:540-345-2606
Mailing Address - Fax:
Practice Address - Street 1:2328 PETERS CREEK RD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-1621
Practice Address - Country:US
Practice Address - Phone:540-345-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704017856101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health