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General NPI Number Information
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NPI Number | 1629253414
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Entity Type | Individual
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Provider Name | CAROLE LEIGH CAMPBELL SWIECICKI PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 2834 TRADEWIND DR
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City | MOUNT PLEASANT
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State | SC
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Zip | 29466-7983
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Country | US
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Telephone | 843-725-8175
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 WINNOWING WAY UNIT 102
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City | MOUNT PLEASANT
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State | SC
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Zip | 29466-7531
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Country | US
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Telephone | 843-874-8526
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810003901
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1327
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License Number State | SC
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