Provider Demographics
NPI:1730397837
Name:SWAIN THERAPY & COUNSELING, LLC
Entity type:Organization
Organization Name:SWAIN THERAPY & COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, DEVELOPMENTAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:708-790-1457
Mailing Address - Street 1:PO BOX 2365
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-8365
Mailing Address - Country:US
Mailing Address - Phone:708-790-1457
Mailing Address - Fax:708-841-0129
Practice Address - Street 1:14731 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:DOLTON
Practice Address - State:IL
Practice Address - Zip Code:60419-2213
Practice Address - Country:US
Practice Address - Phone:708-790-1457
Practice Address - Fax:708-841-0129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty