Healthcare Provider Details

I. General information

NPI: 1124284930
Provider Name (Legal Business Name): ALDENA K SWEENEY LCDCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALDENA K ROGERS

II. Dates (important events)

Enumeration Date: 07/31/2008
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W SOUTH BOUNDARY ST BLDG 6
PERRYSBURG OH
43551-5235
US

IV. Provider business mailing address

511 PERRY ST
DEFIANCE OH
43512-2123
US

V. Phone/Fax

Practice location:
  • Phone: 614-339-0806
  • Fax: 419-784-2523
Mailing address:
  • Phone: 419-782-9920
  • Fax: 419-784-2523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: