Provider Demographics
NPI:1780473033
Name:SWEENEY, ALISSA RENEE (LLMSW)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:RENEE
Last Name:SWEENEY
Suffix:
Gender:
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 E 8TH ST STE 246
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3751
Mailing Address - Country:US
Mailing Address - Phone:616-827-7807
Mailing Address - Fax:616-828-0293
Practice Address - Street 1:430 E 8TH ST STE 246
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3751
Practice Address - Country:US
Practice Address - Phone:616-827-7807
Practice Address - Fax:616-828-0293
Is Sole Proprietor?:No
Enumeration Date:2025-05-03
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511164971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical