Provider Demographics
NPI:1962948554
Name:SWS PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:SWS PSYCHOTHERAPY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:423-509-8765
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-0247
Mailing Address - Country:US
Mailing Address - Phone:423-805-2514
Mailing Address - Fax:423-531-2487
Practice Address - Street 1:6778 EXECUTIVE OAK LN
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1970
Practice Address - Country:US
Practice Address - Phone:423-805-2514
Practice Address - Fax:423-531-2487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN64431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty