Healthcare Provider Details

I. General information

NPI: 1932023363
Provider Name (Legal Business Name): JESSICA DAWN SWIFT CCSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9910 INDIAN SCHOOL RD NE STE 208
ALBUQUERQUE NM
87112-2971
US

IV. Provider business mailing address

221 VERMONT ST NE APT B
ALBUQUERQUE NM
87108-3193
US

V. Phone/Fax

Practice location:
  • Phone: 505-227-5211
  • Fax:
Mailing address:
  • Phone: 505-227-5211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: