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Individual
TIMOTHY SWANSON
Active
Individual
TIMOTHY SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LCPC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180-000950
IL
101YP2500X
Professional Counselor
Primary
5120-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124039367
—
WI
01
—
5615096
BC/BS OF AMERICA
IL
Enumeration date
08/11/2006
Last updated
08/20/2013
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