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Individual

CHARLA A CHENOWETH-SWIFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
916 ARIZONA AVE STE A, TRINIDAD, CO 81082-2118
(719) 680-4047
Mailing address
PO BOX 940, TRINIDAD, CO 81082-0940
(719) 680-4047

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CSW.09924146
CO
1041C0700X
Clinical Social Worker
LSCSW 4157
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200634150B
KS
Enumeration date
01/22/2010
Last updated
06/21/2019
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