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NPI Code Detail

MEDICARE: MALLORY DAWN SWANTEK PLADC, PLMHP

MEDICARE: MALLORY DAWN SWANTEK PLADC, PLMHP
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
1101YM0800XMental Health Counselor2652NE
2101YA0400XAddiction (Substance Use Disorder) CounselorP-1510NE
3101YM0800XMental Health Counselor11293NE

General Provider Information

NPI Number : 1578086070
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORY DAWN SWANTEK PLADC, PLMHP
Provider Business Mailing Address
First Line : PO BOX 1800
Second Line :
City : COLUMBUS
State : NE
Zip : 68602-1800
Country : US
Telephone Number : 402-564-7118
Fax Number :
Provider Business Practice Location Address
First Line : 4508 38TH ST
Second Line : STE 165
City : COLUMBUS
State : NE
Zip : 68601-2131
Country : US
Telephone Number : 402-788-4187
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2017
Last Update Date : 12/09/2025

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