Active NPI
Connie Marie Swanson, MFT
- Professional Counselor
- Redwood City, CA
National Provider Identifier
1861547242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 41585
- Practice address
- 611 Veterans Blvd Ste 119
Redwood City, CA 94063-1462 - Phone
- (650) 504-4655
- Fax
- (650) 365-4566
- NPI assigned
- Jan 24, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 41585 | CA | Primary |
Addresses
Primary practice location
611 Veterans Blvd Ste 119
Redwood City, CA 94063-1462
Mailing address
611 Veterans Blvd Ste 119
Redwood City, CA 94063-1462
Phone (650) 504-4655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 8, 2026 through Jan 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41585 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344297600000",
"number": "1861547242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 VETERANS BLVD STE 119",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631462",
"telephone_number": "650-504-4655",
"fax_number": "650-365-4566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 VETERANS BLVD STE 119",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631462",
"telephone_number": "650-504-4655",
"fax_number": "650-365-4566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSON",
"first_name": "CONNIE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2012-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "41585",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.