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Individual

MR. HOLLIS STEPHEN SWINK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, ICCS, LCPC, CAAD

Contact information

Practice address
1101 STATE ST, QUINCY, IL 62301-4958
(217) 228-0126
Mailing address
1130 S 24TH ST, QUINCY, IL 62301-6133
(217) 228-0126

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14592
IL
101YP2500X
Professional Counselor
Primary
180-003697
IL

Other

Enumeration date
01/16/2012
Last updated
01/16/2012
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