Active NPI
Carrie Swiderski, PSYD
- Professional Counselor
- Huntington Beach, CA
National Provider Identifier
1225174907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 003660
- Practice address
- 1002 Georgia St Unit 104
Huntington Beach, CA 92648-4364 - Phone
- (860) 417-9110
- NPI assigned
- Jan 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Professional Counselor | 101YP2500X | 003660 | CT | Primary |
Addresses
Primary practice location
1002 Georgia St Unit 104
Huntington Beach, CA 92648-4364
Mailing address
66 Colonial Rd
Watertown, CT 06795-3106
Phone (860) 417-9110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1307606 | Medicaid | MA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | other | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003660 | CT | MD | Professional Counselor |
Interoperability endpoints
- carrie.swiderski.p1@direct.wheelerclinic.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567987200000",
"number": "1225174907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 COLONIAL RD",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "067953106",
"telephone_number": "860-417-9110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 GEORGIA ST UNIT 104",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926484364",
"telephone_number": "860-417-9110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWIDERSKI",
"first_name": "CARRIE",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2019-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "003660",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1307606",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "other",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "other",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "other",
"address_1": "1002 Georgia St Unit 104",
"city": "Huntington Beach",
"state": "CA",
"country_code": "US",
"postal_code": "926484364",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Huntington Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.