Healthcare Provider Details

I. General information

NPI: 1033686456
Provider Name (Legal Business Name): JOHN SWASEY LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 OCEAN AVE APT 3
OLD ORCHARD BEACH ME
04064-1700
US

IV. Provider business mailing address

91 OCEAN AVE APT 3
OLD ORCHARD BEACH ME
04064-1700
US

V. Phone/Fax

Practice location:
  • Phone: 603-312-0751
  • Fax:
Mailing address:
  • Phone: 603-312-0751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC6439
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: