Healthcare Provider Details

I. General information

NPI: 1033920103
Provider Name (Legal Business Name): GHALYSA CHARA LERA SWANN MFTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GHALYSA CHARA LERA SWANN-WHITE MFTI

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 N TUXEDO AVE
CHATTANOOGA TN
37411-3728
US

IV. Provider business mailing address

1101 W 40TH ST UNIT 2225
CHATTANOOGA TN
37409-1379
US

V. Phone/Fax

Practice location:
  • Phone: 877-358-2998
  • Fax: 423-405-6346
Mailing address:
  • Phone: 877-358-2998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2424
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: