Provider Demographics
NPI:1548059298
Name:SWENDSEN, DESIREE LEIGH
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:LEIGH
Last Name:SWENDSEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-5453
Mailing Address - Country:US
Mailing Address - Phone:475-344-8560
Mailing Address - Fax:
Practice Address - Street 1:50 FITCH ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1366
Practice Address - Country:US
Practice Address - Phone:203-361-9166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health