Provider Demographics
NPI:1619845229
Name:SWASEY, DOMINIC (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:DOMINIC
Middle Name:
Last Name:SWASEY
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 BERT LN
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-1079
Mailing Address - Country:US
Mailing Address - Phone:734-334-6992
Mailing Address - Fax:
Practice Address - Street 1:243 BERT LN
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-1079
Practice Address - Country:US
Practice Address - Phone:734-334-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704311978363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health