=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922446228
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DIANA L SWARTZ LCPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/07/2013
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 108 N FRONT ST
-----------------------------------------------------
City | TOWNSEND
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59644-2228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-980-0672
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 207 N CHERRY ST
-----------------------------------------------------
City | TOWNSEND
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59644-2403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-761-0002
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LPC-1474
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | BBH-LCPC-TMP-25423
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------