Provider Demographics
NPI:1679639744
Name:MCSWEENEY, MAUREEN (PHD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:MCSWEENEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 CLOWER CREEK DR
Mailing Address - Street 2:APT GR120
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8926
Mailing Address - Country:US
Mailing Address - Phone:917-612-3150
Mailing Address - Fax:718-744-9540
Practice Address - Street 1:1217 S EAST AVE
Practice Address - Street 2:STE 209
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2329
Practice Address - Country:US
Practice Address - Phone:917-612-3150
Practice Address - Fax:718-744-9540
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY9316103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV5J151Medicare ID - Type Unspecified