Provider Demographics
NPI:1669579512
Name:SWARD, JON MICHAEL (PHD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:MICHAEL
Last Name:SWARD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 E 12TH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-5264
Mailing Address - Country:US
Mailing Address - Phone:620-341-5807
Mailing Address - Fax:620-341-5801
Practice Address - Street 1:1512 W 6TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2400
Practice Address - Country:US
Practice Address - Phone:620-343-1711
Practice Address - Fax:620-341-5801
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLCPC 181101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional