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General NPI Number Information
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NPI Number | 1235271503
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Entity Type | Individual
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Provider Name | KAMBI ANN SWAN LPC
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1210 DAVIE AVE
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City | STATESVILLE
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State | NC
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Zip | 28677-3512
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Country | US
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Telephone | 704-437-1079
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Fax | 704-870-3122
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Provider Business Mailing Address
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Address Line | 136 TREEBARK RD
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City | STATESVILLE
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State | NC
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Zip | 28625-1234
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Country | US
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Telephone | 704-437-1079
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Fax | 704-870-3312
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4881
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License Number State | NC
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