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1033920103 NPI number — GHALYSA CHARA LERA SWANN MFTI

NPI Number: 1033920103
Health Care Provider/Practitioner: GHALYSA CHARA LERA SWANN MFTI

Information about “1033920103” NPI (GHALYSA CHARA LERA SWANN MFTI) exists in 1033920103 in HTML format HTML  |  1033920103 in plain Text format TXT  |  1033920103 in PDF (Portable Document Format) PDF  |  1033920103 in an XML format XML  formats.

NPI Number : 1033920103 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033920103",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SWANN",
    "FirstName": "GHALYSA",
    "MiddleName": "CHARA LERA",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MFTI",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "SWANN-WHITE",
    "OtherFirstName": "GHALYSA",
    "OtherMiddleName": "CHARA LERA",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MFTI",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "1101 W 40TH ST UNIT 2225",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHATTANOOGA",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37409-1379",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "877-358-2998",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7 N TUXEDO AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHATTANOOGA",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37411-3728",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "877-358-2998",
    "PracticeLocationAddressFaxNumber": "423-405-6346",
    "EnumerationDate": "01/16/2025",
    "LastUpdateDate": "03/04/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "2424",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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