Provider Demographics
NPI:1982032447
Name:SWEET, TRACI-MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TRACI-MARIE
Middle Name:
Last Name:SWEET
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:TRACI-MARIE
Other - Middle Name:S
Other - Last Name:KASPARIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14704 ADINA LN
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-5745
Mailing Address - Country:US
Mailing Address - Phone:508-579-0000
Mailing Address - Fax:
Practice Address - Street 1:14704 ADINA LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-5745
Practice Address - Country:US
Practice Address - Phone:508-579-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No175L00000XOther Service ProvidersHomeopath