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General NPI Number Information
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NPI Number | 1295791473
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Entity Type | Individual
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Provider Name | JULIE DAWN SWANSON MA LPCC
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Gender | Female
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 1001 W BROADWAY STE D 2700 F1 FARMINGTON AVE.
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City | FARMINGTON
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State | NM
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Zip | 87401-5638
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Country | US
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Telephone | 505-566-0353
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Fax | 505-326-7879
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Provider Business Mailing Address
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Address Line | 1001 W BROADWAY STE D 2344 E16TH SST
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City | FARMINGTON
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State | NM
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Zip | 87401-5638
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Country | US
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Telephone | 505-566-0353
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Fax | 505-325-9113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0154
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License Number State | NM
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