Provider Demographics
NPI:1588944003
Name:SWAN, KARRIE LEA (LMHC)
Entity type:Individual
Prefix:DR
First Name:KARRIE
Middle Name:LEA
Last Name:SWAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18710 S NEVADA ST # A
Mailing Address - Street 2:
Mailing Address - City:SPANGLE
Mailing Address - State:WA
Mailing Address - Zip Code:99031-9400
Mailing Address - Country:US
Mailing Address - Phone:509-990-3478
Mailing Address - Fax:
Practice Address - Street 1:18710 S NEVADA ST # A
Practice Address - Street 2:
Practice Address - City:SPANGLE
Practice Address - State:WA
Practice Address - Zip Code:99031-9400
Practice Address - Country:US
Practice Address - Phone:509-990-3478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60689571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health