Provider Demographics
NPI:1659947737
Name:SWANN, LETITIA E (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:LETITIA
Middle Name:E
Last Name:SWANN
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1605
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-1605
Mailing Address - Country:US
Mailing Address - Phone:303-396-4371
Mailing Address - Fax:
Practice Address - Street 1:65 NAVAJO TRL
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:CO
Practice Address - Zip Code:80466-8502
Practice Address - Country:US
Practice Address - Phone:303-396-4371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018073101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor