Individual
CHARLES JOSEPH SWIERKOSZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1751 OLD PECOS TRL, SUITE E, SANTA FE, NM 87505-4706
(505) 988-4131
(505) 992-6145
Mailing address
1751 OLD PECOS TRAIL, SUITE E, SANTA FE, NM 87505
(505) 988-4131
(505) 992-6145
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0215
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1096
AGENCY MEDICAID #
NM
Enumeration date
10/03/2006
Last updated
07/23/2014
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