Provider Demographics
NPI:1295891711
Name:SWEENEY, DENNIS JOHN (MALMHC)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:JOHN
Last Name:SWEENEY
Suffix:
Gender:M
Credentials:MALMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CUNNINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1002
Mailing Address - Country:US
Mailing Address - Phone:508-893-0631
Mailing Address - Fax:
Practice Address - Street 1:770 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLLISTON
Practice Address - State:MA
Practice Address - Zip Code:01746-2169
Practice Address - Country:US
Practice Address - Phone:508-893-0631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1462101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1462OtherLMHC NUMBET