Healthcare Provider Details

I. General information

NPI: 1154669687
Provider Name (Legal Business Name): ANDREA L SWAILS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2013
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 W 9TH ST STE 100
CLEVELAND OH
44113-1252
US

IV. Provider business mailing address

1468 W 9TH ST STE 100
CLEVELAND OH
44113-1252
US

V. Phone/Fax

Practice location:
  • Phone: 216-546-4141
  • Fax: 866-704-0173
Mailing address:
  • Phone: 216-546-4141
  • Fax: 866-704-0173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0034227
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN363557
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: