Provider Demographics
NPI:1902906407
Name:SWENSON, ERIN K (THM, PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:K
Last Name:SWENSON
Suffix:
Gender:F
Credentials:THM, PHD
Other - Prefix:DR
Other - First Name:ERIC
Other - Middle Name:K
Other - Last Name:SWENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:659 AUBURN AVE NE APT 258
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1981
Mailing Address - Country:US
Mailing Address - Phone:404-312-5677
Mailing Address - Fax:404-565-2633
Practice Address - Street 1:659 AUBURN AVE NE APT 258
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1981
Practice Address - Country:US
Practice Address - Phone:404-312-5677
Practice Address - Fax:404-565-2633
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT000455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAMFT000455OtherPROFESSIONAL LICENSE