Provider Demographics
NPI:1952889396
Name:SWEENEY, CHRISTINE RACHEL (LICSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:RACHEL
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7567 CENTRAL PARKE BLVD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6852
Mailing Address - Country:US
Mailing Address - Phone:513-770-3231
Mailing Address - Fax:513-770-5541
Practice Address - Street 1:7567 CENTRAL PARKE BLVD
Practice Address - Street 2:SUITEE
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-8947
Practice Address - Country:US
Practice Address - Phone:513-770-3231
Practice Address - Fax:513-770-5541
Is Sole Proprietor?:No
Enumeration Date:2018-07-29
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113099104100000X
OHI.21027141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker