Individual provider Active NPI

Nova Annmay Swanstrom, LPA

  • Psychologist
  • Wilmington, NC
National Provider Identifier
1659570844
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3419 Issued in NC
Practice address
1920 Tradd CT
Delta Behavioral Health
Wilmington, NC 28401-6637
Phone
(910) 343-6890
Fax
(910) 332-1233
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3419 NC Primary

Addresses

Primary practice location

1920 Tradd CT
Delta Behavioral Health
Wilmington, NC 28401-6637

Mailing address

1920 Tradd CT
Delta Behavioral Health
Wilmington, NC 28401-6637
Phone (910) 343-6890

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

LicenseStateTypeSpecialty
3419NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1659570844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 TRADD CT",
            "address_2": "DELTA BEHAVIORAL HEALTH",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016637",
            "telephone_number": "910-343-6890",
            "fax_number": "910-332-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 TRADD CT",
            "address_2": "DELTA BEHAVIORAL HEALTH",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016637",
            "telephone_number": "910-343-6890",
            "fax_number": "910-332-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSTROM",
        "first_name": "NOVA",
        "middle_name": "ANNMAY",
        "credential": "LPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.