Provider Demographics
NPI:1841555778
Name:SWEET, JENNIFER M (LAC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:M
Last Name:SWEET
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1589
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-1589
Mailing Address - Country:US
Mailing Address - Phone:501-315-3344
Mailing Address - Fax:870-856-3334
Practice Address - Street 1:218 DOGWOOD HOLLOW RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560-7942
Practice Address - Country:US
Practice Address - Phone:501-315-3344
Practice Address - Fax:870-856-3334
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2210016101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor