Healthcare Provider Details

I. General information

NPI: 1508053687
Provider Name (Legal Business Name): CHERYL SWENNY & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S. WALNUT ST
ROCHESTER IL
62563
US

IV. Provider business mailing address

PO BOX 18
ROCHESTER IL
62563-0018
US

V. Phone/Fax

Practice location:
  • Phone: 217-498-7600
  • Fax: 217-498-8093
Mailing address:
  • Phone: 217-498-7600
  • Fax: 217-498-8093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name: MRS. CHERYL SUE SWENNY
Title or Position: PRESIDENT
Credential: LCPC
Phone: 217-498-7600