Provider Demographics
NPI:1457569089
Name:SWAHNBERG, NADINE ANN
Entity Type:Individual
Prefix:DR
First Name:NADINE
Middle Name:ANN
Last Name:SWAHNBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:SWAHNBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, MDIV
Mailing Address - Street 1:1458 S WARD ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3870
Mailing Address - Country:US
Mailing Address - Phone:303-969-9238
Mailing Address - Fax:303-969-0125
Practice Address - Street 1:1458 S WARD ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-3870
Practice Address - Country:US
Practice Address - Phone:303-969-9238
Practice Address - Fax:303-969-0125
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral