Healthcare Provider Details

I. General information

NPI: 1932962792
Provider Name (Legal Business Name): CYNTHIA E SWINTON-JACKSON PHD, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 NYACK AVE
LANSDOWNE PA
19050-2809
US

IV. Provider business mailing address

74 NYACK AVE
LANSDOWNE PA
19050-2809
US

V. Phone/Fax

Practice location:
  • Phone: 215-422-2257
  • Fax:
Mailing address:
  • Phone: 215-422-2257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC015374
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: