| Adult Youth At Swanson Counseling | |
|
1826 E Platte Ave Ste 102 Colorado Springs CO 80909-5738 | |
| (719) 358-6559 | |
| Not Available |
| Full Name | Adult Youth At Swanson Counseling |
|---|---|
| Speciality | Counselor |
| Location | 1826 E Platte Ave Ste 102, Colorado Springs, Colorado |
| Authorized Official Name and Position | Timothy Swanson (CEO) |
| Authorized Official Contact | 7193586559 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult Youth At Swanson Counseling 1826 E Platte Ave Ste 102 Colorado Springs CO 80909-5738 Ph: (719) 358-6559 | Adult Youth At Swanson Counseling 1826 E Platte Ave Ste 102 Colorado Springs CO 80909-5738 Ph: (719) 358-6559 |
| NPI Number | 1831814888 |
|---|---|
| Provider Enumeration Date | 10/11/2022 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Medicare PECOS PAC ID | 4587985924 |
|---|---|
| Medicare Enrollment ID | O20230125001123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831814888 | NPI | - | NPPES |
| 9000210533 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Timothy J Swanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508258302 PECOS PAC ID: 8426379876 Enrollment ID: I20150610002313 |
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