Provider Demographics
NPI:1962848598
Name:SWANSON, ELAINA C (MS, LPC, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:C
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MS, LPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W BONBRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5046
Mailing Address - Country:US
Mailing Address - Phone:575-725-5735
Mailing Address - Fax:
Practice Address - Street 1:502 W BONBRIGHT ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5046
Practice Address - Country:US
Practice Address - Phone:575-725-5735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0158671101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health