Provider Demographics
NPI:1932759982
Name:SWIFT, SHAKESHA MONIQUE (MA)
Entity type:Individual
Prefix:
First Name:SHAKESHA
Middle Name:MONIQUE
Last Name:SWIFT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26142
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-6142
Mailing Address - Country:US
Mailing Address - Phone:888-763-7837
Mailing Address - Fax:888-376-7135
Practice Address - Street 1:901 NW 8TH AVE STE B3-1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-5011
Practice Address - Country:US
Practice Address - Phone:888-763-7837
Practice Address - Fax:888-376-7135
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor