Provider Demographics
NPI:1093429995
Name:SWEENEY, COLLEEN (MA)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006B MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02576-1347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56 CHERRY ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2608
Practice Address - Country:US
Practice Address - Phone:508-256-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health