Provider Demographics
NPI:1851414916
Name:SWANSON, TORRE K (MS LCPC)
Entity Type:Individual
Prefix:MS
First Name:TORRE
Middle Name:K
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MS LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 N GREENLEAF ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3393
Mailing Address - Country:US
Mailing Address - Phone:847-975-0191
Mailing Address - Fax:847-336-8109
Practice Address - Street 1:135 N GREENLEAF ST
Practice Address - Street 2:SUITE 230
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3393
Practice Address - Country:US
Practice Address - Phone:847-975-0191
Practice Address - Fax:847-336-8109
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health