Organization
ADULT YOUTH @ SWANSON COUNSELING LLC
Active
Parent organization
ADULT YOUTH @ SWANSON COUNSELING
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADULT YOUTH @ SWANSON COUNSELING
Authorized official
TIMOTHY SWANSON (OWNER)
(719) 641-4917
Entity
Organization
Contact information
Practice address
803 W 4TH ST STE D, PUEBLO, CO 81003-2392
(719) 225-8639
Mailing address
803 W 4TH ST STE D, PUEBLO, CO 81003-2392
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB7020
CO
101YM0800X
Mental Health Counselor
CSWOO923464
CO
Other
Enumeration date
10/02/2017
Last updated
03/17/2018
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