Individual
SHANNON D SWARTHOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
135 COLORADO ST E, SAINT PAUL, MN 55107-2244
(612) 454-2131
(651) 489-6458
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303820
MN
324500000X
Substance Abuse Rehabilitation Facility
Primary
303820
MN
Other
Enumeration date
07/10/2014
Last updated
05/22/2025
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