Provider Demographics
NPI:1720544299
Name:SWAN COUNSELING LLC
Entity Type:Organization
Organization Name:SWAN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SATWANT
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANNA
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S, LICDC-CS
Authorized Official - Phone:440-725-4971
Mailing Address - Street 1:19314 SARATOGA TRL
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7260
Mailing Address - Country:US
Mailing Address - Phone:440-725-4971
Mailing Address - Fax:
Practice Address - Street 1:16600 W SPRAGUE RD STE 190
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-6398
Practice Address - Country:US
Practice Address - Phone:440-725-4971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0255949Medicaid