Provider Demographics
NPI:1205257052
Name:SWEENEY, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 S YOSEMITE ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1442
Mailing Address - Country:US
Mailing Address - Phone:303-694-3360
Mailing Address - Fax:303-694-3363
Practice Address - Street 1:6901 S YOSEMITE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1442
Practice Address - Country:US
Practice Address - Phone:303-694-3360
Practice Address - Fax:303-694-3363
Is Sole Proprietor?:No
Enumeration Date:2013-12-20
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6902101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)