Healthcare Provider Details

I. General information

NPI: 1770768236
Provider Name (Legal Business Name): RICHARD J. SWISTEK M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CHEROKEE BLVD STE 305
CHATTANOOGA TN
37405-3886
US

IV. Provider business mailing address

PO BOX 1101
COLLEGEDALE TN
37315-1101
US

V. Phone/Fax

Practice location:
  • Phone: 423-355-1646
  • Fax:
Mailing address:
  • Phone: 423-432-7964
  • Fax: 423-702-5512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC0000002126
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLPC0000002126
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: