Provider Demographics
NPI:1114030608
Name:SWEENEY, MEGAN A (LPC, CSAC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:A
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 N WITCHDUCK RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6544
Mailing Address - Country:US
Mailing Address - Phone:757-497-3670
Mailing Address - Fax:757-499-1947
Practice Address - Street 1:256 N WITCHDUCK RD
Practice Address - Street 2:SUITE G
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6544
Practice Address - Country:US
Practice Address - Phone:757-497-3670
Practice Address - Fax:757-499-1947
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710101795101YA0400X
VA0701003603101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA193180OtherBLUE CROSS BLUE SHEILD
VA010272271Medicaid
VA379096OtherTRICARE
VAAO802344MOtherSENTARA OPTIMA PPO/POS