Healthcare Provider Details

I. General information

NPI: 1235763111
Provider Name (Legal Business Name): SWANN CLINIC FOR BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2020
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 GRAND AVE SUITE 005
GLENWOOD SPRINGS CO
81601-3642
US

IV. Provider business mailing address

1001 GRAND AVE SUITE 005
GLENWOOD SPRINGS CO
81601-3642
US

V. Phone/Fax

Practice location:
  • Phone: 404-819-8900
  • Fax: 970-549-2874
Mailing address:
  • Phone: 970-924-0484
  • Fax: 970-549-2874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JESSICA NICHOLE HARDY SWANN
Title or Position: OWNER
Credential: PSY.D.
Phone: 404-819-8900