Healthcare Provider Details
I. General information
NPI: 1477485613
Provider Name (Legal Business Name): FOUR CORNERS PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2420 COUNTY ROAD 250
DURANGO CO
81301-6962
US
IV. Provider business mailing address
2420 COUNTY ROAD 250
DURANGO CO
81301-6962
US
V. Phone/Fax
- Phone: 970-799-0326
- Fax:
- Phone: 970-799-0326
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BLAIR
SWEARINGEN
Title or Position: PMHNP
Credential:
Phone: 970-799-0326