Provider Demographics
NPI:1477923860
Name:SWEENEY, TERESA (LMSW)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 GRASSY PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2876
Mailing Address - Country:US
Mailing Address - Phone:203-456-3364
Mailing Address - Fax:
Practice Address - Street 1:182 GRASSY PLAIN ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2876
Practice Address - Country:US
Practice Address - Phone:203-456-3364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0006451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical