Healthcare Provider Details

I. General information

NPI: 1790608123
Provider Name (Legal Business Name): THOMAS SWIM MA, ALC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 S SAINT ANDREWS ST
DOTHAN AL
36301-2652
US

IV. Provider business mailing address

104 HUNTER ST
DOTHAN AL
36305-9739
US

V. Phone/Fax

Practice location:
  • Phone: 334-232-8409
  • Fax:
Mailing address:
  • Phone: 334-232-8409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberALC06067
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: