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General NPI Number Information
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NPI Number | 1043655715
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Entity Type | Organization
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Legal Business Name | SWIFT CREEK COUNSELING, LLC
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 2801 BOULEVARD SUITE F
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2323
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Country | US
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Telephone | 804-334-9862
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Fax |
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Provider Business Mailing Address
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Address Line | 2801 BOULEVARD SUITE F
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2323
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Country | US
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Telephone | 804-334-9862
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MRS. ELLEN HOPE THORNTON-LOVE
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Credential | LCSW
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Telephone | 804-334-9862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 090400636
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License Number State | VA
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