Healthcare Provider Details

I. General information

NPI: 1053754150
Provider Name (Legal Business Name): MRS. HEIDI ANN SWEENEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5025 E WASHINGTON ST STE 112
PHOENIX AZ
85034-7438
US

IV. Provider business mailing address

5025 E WASHINGTON ST STE 112
PHOENIX AZ
85034-7438
US

V. Phone/Fax

Practice location:
  • Phone: 602-759-8182
  • Fax:
Mailing address:
  • Phone: 602-759-8182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: