Provider Demographics
NPI:1194392167
Name:SWENSON, SHANDRA (LPC)
Entity type:Individual
Prefix:
First Name:SHANDRA
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 DTC PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3010
Mailing Address - Country:US
Mailing Address - Phone:720-839-1214
Mailing Address - Fax:
Practice Address - Street 1:5310 DTC PKWY STE E
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3010
Practice Address - Country:US
Practice Address - Phone:720-839-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018265101Y00000X
CO0017465101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor