Provider Demographics
NPI:1134652365
Name:SWEENEY, KIM M
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:M
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 INDUSTRIAL WAY W
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2268
Mailing Address - Country:US
Mailing Address - Phone:732-982-3001
Mailing Address - Fax:732-982-3933
Practice Address - Street 1:6 INDUSTRIAL WAY W
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2268
Practice Address - Country:US
Practice Address - Phone:732-982-3001
Practice Address - Fax:732-982-3933
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health