MEDICARE: DANIELLE NOEL SWALES PHD

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	103TH0100X	Health Service Psychologist	6476	NC
2	103TC0700X	Clinical Psychologist	6476	NC
3	103TC2200X	Clinical Child & Adolescent Psychologist	PSY.0006940	CO

General Provider Information

NPI Number	:	1356112411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE NOEL SWALES PHD

Provider Business Mailing Address
First Line	:	PO BOX 110429
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80042-0429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13123 E 16TH AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-7106
Country	:	US
Telephone Number	:	720-777-1234
Fax Number	:

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

Provider Enumeration Date	:	01/09/2024
Last Update Date	:	02/03/2026

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