Provider Demographics
NPI:1093251464
Name:SWEATT, SORENA LYNN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:SORENA
Middle Name:LYNN
Last Name:SWEATT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:SORENA
Other - Middle Name:LYNN
Other - Last Name:EADDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:7645 E ARBORY CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5537
Mailing Address - Country:US
Mailing Address - Phone:302-312-0363
Mailing Address - Fax:
Practice Address - Street 1:6811 KENILWORTH AVE STE 500
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1318
Practice Address - Country:US
Practice Address - Phone:302-715-2503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG500819961041S0200X
MD212121041S0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool