Provider Demographics
NPI:1649255183
Name:SWEENEY, MICHAEL EUGENE JR (RN PC, PMHCNS-BS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:EUGENE
Last Name:SWEENEY
Suffix:JR
Gender:M
Credentials:RN PC, PMHCNS-BS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:30 TAUNTON GRN
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3243
Mailing Address - Country:US
Mailing Address - Phone:508-880-6666
Mailing Address - Fax:508-880-6655
Practice Address - Street 1:30 TAUNTON GRN
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3243
Practice Address - Country:US
Practice Address - Phone:508-880-6666
Practice Address - Fax:508-880-6655
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN190759364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health