Provider Demographics
NPI:1073634747
Name:SWEET, CYNTHIA LOUISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:SWEET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 CURT DR # A
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-1119
Mailing Address - Country:US
Mailing Address - Phone:217-352-5179
Mailing Address - Fax:217-352-7817
Practice Address - Street 1:1315 CURT DR # A
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-1119
Practice Address - Country:US
Practice Address - Phone:217-352-5179
Practice Address - Fax:217-352-7817
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490080491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical