Provider Demographics
NPI:1740721752
Name:TAMERA J. SWEETON
Entity type:Organization
Organization Name:TAMERA J. SWEETON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMERA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:SWEETON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:405-659-6518
Mailing Address - Street 1:513 N MUR LEN RD STE A
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1224
Mailing Address - Country:US
Mailing Address - Phone:405-659-6518
Mailing Address - Fax:417-338-1279
Practice Address - Street 1:513 N MUR LEN RD
Practice Address - Street 2:SUITE A
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1318
Practice Address - Country:US
Practice Address - Phone:405-659-6518
Practice Address - Fax:417-338-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2507101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty