Provider Demographics
NPI:1073835542
Name:SWEENEY-ZARKOWSKY, KERRY J (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KERRY
Middle Name:J
Last Name:SWEENEY-ZARKOWSKY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:KERRY
Other - Middle Name:J
Other - Last Name:SWEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:141 COLIN DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EAST YAPHANK
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1521
Mailing Address - Country:US
Mailing Address - Phone:631-205-5820
Mailing Address - Fax:631-205-5826
Practice Address - Street 1:141 COLIN DR
Practice Address - Street 2:SUITE 1
Practice Address - City:EAST YAPHANK
Practice Address - State:NY
Practice Address - Zip Code:11967-1521
Practice Address - Country:US
Practice Address - Phone:631-205-5820
Practice Address - Fax:631-205-5826
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078330-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker