Healthcare Provider Details

I. General information

NPI: 1649255183
Provider Name (Legal Business Name): MICHAEL EUGENE SWEENEY JR. RN PC, PMHCNS-BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 TAUNTON GRN
TAUNTON MA
02780-3243
US

IV. Provider business mailing address

30 TAUNTON GRN
TAUNTON MA
02780-3243
US

V. Phone/Fax

Practice location:
  • Phone: 508-880-6666
  • Fax: 508-880-6655
Mailing address:
  • Phone: 508-880-6666
  • Fax: 508-880-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN190759
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: