Provider Demographics
NPI:1952703662
Name:SWANSON, HARRY (LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:SWANSON
Suffix:
Gender:M
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:MI
Mailing Address - Zip Code:49911-1706
Mailing Address - Country:US
Mailing Address - Phone:906-285-2738
Mailing Address - Fax:
Practice Address - Street 1:101 E MARY ST
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:MI
Practice Address - Zip Code:49911-1457
Practice Address - Country:US
Practice Address - Phone:906-285-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014511101YP2500X
MIC-03029101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)