Provider Demographics
NPI:1407528730
Name:SWAIN, COLLEEN C (T-LMHC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:C
Last Name:SWAIN
Suffix:
Gender:F
Credentials:T-LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 BILLY SUNDAY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8048
Mailing Address - Country:US
Mailing Address - Phone:515-337-1764
Mailing Address - Fax:
Practice Address - Street 1:614 BILLY SUNDAY RD STE 100
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8048
Practice Address - Country:US
Practice Address - Phone:515-337-1764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health