Provider Demographics
NPI:1881172922
Name:SWEENEY, ELISABETH QUINTRELL (PHD)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:QUINTRELL
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 INGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-1426
Mailing Address - Country:US
Mailing Address - Phone:404-731-0598
Mailing Address - Fax:
Practice Address - Street 1:2209 ABBOTT MARTIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215
Practice Address - Country:US
Practice Address - Phone:615-519-8960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3558103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA$$$$$$$$$OtherNO INSURANCE (PRIVATE PAY)