| Doctor Name: | MR. THOMAS SWENSON |
| NPI Number: | 1720357478 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS,LCPC |
| License Number: | 180000455 |
| Business Practice Address: | 4160 Route 83 Suite 210 Long Grove, WI - 60047 |
| Business Phone Number: | 8478211431 |
| Business Fax Number: | 8478211431 |
| Mailing Address: | 4160 Route 83, Suite 210 LONG GROVE |
| State: | IL |
| Postal Code: | 60047 |
| Phone Number: | 8478211431 |
| Fax Number: | 8478211431 |
| NPI Enumeration Date: | 12/27/2011 |
| NPI Last Update Date: | 12/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 180000455 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |