Provider Demographics
NPI:1932307576
Name:SWEENEY, COLLEEN M (LICSW)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MIDDLESEX AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-2773
Mailing Address - Country:US
Mailing Address - Phone:978-658-6889
Mailing Address - Fax:
Practice Address - Street 1:5 MIDDLESEX AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2773
Practice Address - Country:US
Practice Address - Phone:978-658-9889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1141091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical