Adult Youth @ Swanson Counseling LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

ACB7020 Issued in CO

Legal business name

ADULT YOUTH @ SWANSON COUNSELING LLC

Practice address

803 W 4TH St Ste D
Pueblo, CO 81003-2392

Phone

(719) 225-8639

NPI assigned

Oct 2, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

ADULT YOUTH @ SWANSON COUNSELINGAs reported in NPPES

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

Authorized official

Name

Timothy SwansonNPI 1508258302

Title

Owner

Phone

(719) 641-4917

Specialties & licenses 2

Addresses

Part of

Adult Youth Swanson Counseling LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Adult Youth at Swanson Counseling

  • Addiction (Substance Use Disorder) Counselor
  • Colorado Springs, CO
  • NPI 1831814888
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy Swanson

  • Mental Health Counselor
  • Colorado Springs, CO
  • NPI 1508258302

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Linda Lou Randolph, CACIII

  • Addiction (Substance Use Disorder) Counselor
  • Pueblo, CO
  • NPI 1750892469
  NPD (past)

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1730699984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 W 4TH ST STE D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 W 4TH ST STE D",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032392",
            "telephone_number": "719-225-8639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1826 E Platte Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809095738",
            "country_code": "US",
            "telephone_number": "719-641-4917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADULT YOUTH @ SWANSON COUNSELING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADULT YOUTH @ SWANSON COUNSELING",
        "enumeration_date": "2017-10-02",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-641-4917"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACB7020",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "CSWOO923464",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.