Mary Theresa Swenson, EDD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

00808 Issued in MN

Practice address

13750 Crosstown Dr Phase II
Suite 207
Ham Lake, MN 55304-2664

Phone

(763) 413-6971

NPI assigned

Jun 5, 2014

Last updated

Dec 1, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mary Theresa Duren Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Interpretive Leadership Inc

  • Mental Health Counselor
  • Ham Lake, MN
  • NPI 1669873824
  NPD (past) Authorized official
• Interpretive Leadership Incorporated

  • Community/Behavioral Health Agency
  • Andover, MN
  • NPI 1730622861
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1093128233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13750 CROSSTOWN DR NW",
            "address_2": "MOLLY PROFESSIONAL CENTER PHASE II SUITE 207",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "55304",
            "telephone_number": "763-755-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 CROSSTOWN DR PHASE II",
            "address_2": "SUITE 207",
            "city": "HAM LAKE",
            "state": "MN",
            "postal_code": "553042664",
            "telephone_number": "763-413-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWENSON",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "00808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DUREN",
            "middle_name": "THERESA",
            "credential": "LPCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leyla Sanati-Zaker, DC
• Karl Ritchie Schlotterbeck, LP
• Kathrine Schmit
• Danielle Smith, RN
• Hayley Lynn Stumne, DC
• Diana Rose Symens, DPT
• Julie Anne Tarro, CMT
• Imaim Neng Thao, PH.D., L.AC.
• Mitchell Timothy Thilges, DC
• Kiaja Tolzmann, DC

• Mental Health Counselor in Ham Lake, MN
• Providers in Ham Lake, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.