Healthcare Provider Details

I. General information

NPI: 1750505343
Provider Name (Legal Business Name): JOHN MICHAEL SWEARENGIN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 N HAYDEN RD
SCOTTSDALE AZ
85251-6649
US

IV. Provider business mailing address

2155 E FOOTHILL DR
PHOENIX AZ
85024-6527
US

V. Phone/Fax

Practice location:
  • Phone: 480-804-0326
  • Fax: 480-804-0083
Mailing address:
  • Phone: 480-563-7899
  • Fax: 480-563-7899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-11751
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: