| Callie Swaite, Llc | |
|
206 Levesque Ave E Wynne AR 72396-2938 | |
| (870) 318-5623 | |
| Not Available |
| Full Name | Callie Swaite, Llc |
|---|---|
| Speciality | Counselor |
| Location | 206 Levesque Ave E, Wynne, Arkansas |
| Authorized Official Name and Position | Callie Swaite (THERAPIST) |
| Authorized Official Contact | 8703185623 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Callie Swaite, Llc 206 Levesque Ave E Wynne AR 72396-2938 Ph: (870) 318-5623 | Callie Swaite, Llc 206 Levesque Ave E Wynne AR 72396-2938 Ph: (870) 318-5623 |
| NPI Number | 1639846199 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 08/24/2021 |
| Certification Date | 08/24/2021 |
| Medicare PECOS PAC ID | 8022540087 |
|---|---|
| Medicare Enrollment ID | O20241015002693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639846199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Callie Jo Swaite |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063536837 PECOS PAC ID: 0840722807 Enrollment ID: I20241015003033 |
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