MEDICARE: SHANNON LENAYE SWANSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		AZ

General Provider Information

NPI Number	:	1336954999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON LENAYE SWANSON

Provider Business Mailing Address
First Line	:	6295 N SILVERBELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85743-9598
Country	:	US
Telephone Number	:	520-850-2489
Fax Number	:

Provider Business Practice Location Address
First Line	:	3618 E PIMA ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3321
Country	:	US
Telephone Number	:	520-243-3207
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2025
Last Update Date	:	02/11/2025

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Directions to “ SHANNON LENAYE SWANSON ” Practice Location

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