MEDICARE: RUBI SWEANEY LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	17747	TX

General Provider Information

NPI Number	:	1730428871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBI SWEANEY LPC

Provider Business Mailing Address
First Line	:	1501 INVERNESS RD
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-2962
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 UNIVERSITY DR STE 105
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2168
Country	:	US
Telephone Number	:	817-360-2983
Fax Number	:	817-386-5880

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2013
Last Update Date	:	02/09/2013

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Directions to “ RUBI SWEANEY LPC” Practice Location

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