MEDICARE: SWAN COUNSELING LLC

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

General Provider Information

NPI Number	:	1386582401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWAN COUNSELING LLC

Provider Business Mailing Address
First Line	:	522 7TH ST STE 202
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-2756
Country	:	US
Telephone Number	:	605-416-9904
Fax Number	:	605-416-9904

Provider Business Practice Location Address
First Line	:	522 7TH ST STE 202
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-2756
Country	:	US
Telephone Number	:	605-416-9904
Fax Number	:	605-416-9904

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA R SWAN
Credential	:	SWAN
Telephone Number	:	605-416-9904

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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