Provider Demographics
NPI:1730801556
Name:SWINDELL-HEDLUND, ELIZABETH DIANE (MA, ASSOCIATE MFT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DIANE
Last Name:SWINDELL-HEDLUND
Suffix:
Gender:F
Credentials:MA, ASSOCIATE MFT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:DIANE
Other - Last Name:HEDLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:624 HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4448
Mailing Address - Country:US
Mailing Address - Phone:707-496-8644
Mailing Address - Fax:707-445-6124
Practice Address - Street 1:624 HARRIS ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4448
Practice Address - Country:US
Practice Address - Phone:707-441-2051
Practice Address - Fax:707-445-6124
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT134408106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist