Healthcare Provider Details

I. General information

NPI: 1538578299
Provider Name (Legal Business Name): JOCIE SWEENEY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOCELYN BRINEMAN SWEENEY PHD

II. Dates (important events)

Enumeration Date: 08/07/2014
Last Update Date: 08/06/2024
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 CENTRAL AVE STE 2
CHARLOTTE NC
28204-2015
US

IV. Provider business mailing address

811 CENTRAL AVE STE 2
CHARLOTTE NC
28204-2015
US

V. Phone/Fax

Practice location:
  • Phone: 980-236-0734
  • Fax: 980-433-0083
Mailing address:
  • Phone: 980-236-0734
  • Fax: 980-433-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number4697
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4697
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: