Doctor Name: | MR. GEORGE LYNDON SWANBERG |
NPI Number: | 1770672743 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW, LSATP, MAC |
License Number: | 0718000188 |
Business Practice Address: | 4308 Beaver Dam Rd Jeffersonton, VA - 227242001 |
Business Phone Number: | 5403479531 |
Business Fax Number: | 7036917410 |
Mailing Address: | 4308 Beaver Dam Rd, JEFFERSONTON |
State: | VA |
Postal Code: | 227242001 |
Phone Number: | 5403479531 |
Fax Number: | 7036917410 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 0718000188 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |