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General NPI Number Information
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NPI Number | 1619433695
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Entity Type | Individual
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Provider Name | JENNIFER SWENSON LPC
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Gender | Female
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 02/14/2019
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Provider Practice Location Address
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Address Line | 215 W ROMEO RD
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City | ROMEOVILLE
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State | IL
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Zip | 60446-1521
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Country | US
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Telephone | 815-838-2690
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Fax |
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Provider Business Mailing Address
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Address Line | 751 ANDERSON BLVD
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City | GENEVA
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State | IL
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Zip | 60134-1246
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Country | US
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Telephone | 815-474-0319
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Fax |
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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 | 178008813
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License Number State | IL
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