Healthcare Provider Details

I. General information

NPI: 1851811517
Provider Name (Legal Business Name): JESSICA H SWEENEY MA, LMHC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA M HUERTA MA, LMHC, NCC

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 10/15/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1038 SE OCEAN BLVD STE C
STUART FL
34996-2599
US

IV. Provider business mailing address

1038 SE OCEAN BLVD STE C
STUART FL
34996-2599
US

V. Phone/Fax

Practice location:
  • Phone: 772-774-7596
  • Fax: 772-264-3838
Mailing address:
  • Phone: 772-774-7596
  • Fax: 772-264-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14806
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: