Provider Demographics
NPI:1609277219
Name:SWARTOUT, ROLAND (MA)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:
Last Name:SWARTOUT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-1537
Mailing Address - Country:US
Mailing Address - Phone:989-673-6191
Mailing Address - Fax:989-672-2199
Practice Address - Street 1:1332 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9288
Practice Address - Country:US
Practice Address - Phone:989-673-6191
Practice Address - Fax:989-672-3170
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor