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NPI Code Detail

MEDICARE: KELLYN PATRICIA SWANSON

MEDICARE: KELLYN PATRICIA SWANSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPC012196PA

General Provider Information

NPI Number : 1205439742
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLYN PATRICIA SWANSON
Provider Business Mailing Address
First Line : 1000 JEFFERSON ST STE 2C
Second Line :
City : LYNCHBURG
State : VA
Zip : 24504-1724
Country : US
Telephone Number :
Fax Number : 617-807-0958
Provider Business Practice Location Address
First Line : 1950 STREET RD STE 410
Second Line :
City : BENSALEM
State : PA
Zip : 19020-3752
Country : US
Telephone Number : 215-874-8002
Fax Number : 617-807-0958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2020
Last Update Date : 11/18/2020

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Directions to “ KELLYN PATRICIA SWANSON ” Practice Location

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