Basic Information
Provider Information
NPI: 1205260767
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SWINSON
FirstName: KARYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13001 E 17TH PL FL 2
Address2:  
City: AURORA
State: CO
PostalCode: 800452570
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 13001 E 17TH PL FL 2
Address2:  
City: AURORA
State: CO
PostalCode: 800452570
CountryCode: US
TelephoneNumber: 3037241000
FaxNumber: 3037249472
Other Information
ProviderEnumerationDate: 09/02/2013
LastUpdateDate: 05/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSY.0005451COY Behavioral Health & Social Service ProvidersPsychologistClinical
103T00000X  N Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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