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General NPI Number Information
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NPI Number | 1215301908
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Entity Type | Individual
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Provider Name | LISA MICHELE SWANN LPC
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Gender | Female
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 6076 FRANCONIA RD STE D
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City | ALEXANDRIA
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State | VA
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Zip | 22310-1768
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Country | US
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Telephone | 202-380-8706
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Fax |
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Provider Business Mailing Address
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Address Line | 1949 4TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-1211
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Country | US
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Telephone | 202-380-8706
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CACII1170
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PRC14579
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701008307
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License Number State | VA
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