Healthcare Provider Details

I. General information

NPI: 1255994711
Provider Name (Legal Business Name): DYLAN SWEARINGEN IMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2019
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 OHIO PIKE STE 312
CINCINNATI OH
45255-3629
US

IV. Provider business mailing address

431 OHIO PIKE STE 312
CINCINNATI OH
45255-3629
US

V. Phone/Fax

Practice location:
  • Phone: 513-770-1705
  • Fax:
Mailing address:
  • Phone: 513-770-1705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberF.2200285
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM.1900102
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: