Provider Demographics
NPI:1396221339
Name:SWEENEY, ERIN THERESA (LSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:THERESA
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-1803
Mailing Address - Country:US
Mailing Address - Phone:908-868-8161
Mailing Address - Fax:
Practice Address - Street 1:7 ELM ST FL 2
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2147
Practice Address - Country:US
Practice Address - Phone:908-202-6303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10402381041S0200X
NJ44SL06241200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool