Healthcare Provider Details

I. General information

NPI: 1659517886
Provider Name (Legal Business Name): KELLY ANN SWEENEY M.S., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2008
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OXFORD VALLEY RD SUITE 603A
YARDLEY PA
19067-7706
US

IV. Provider business mailing address

PO BOX 269
YARDLEY PA
19067-8269
US

V. Phone/Fax

Practice location:
  • Phone: 267-980-4822
  • Fax:
Mailing address:
  • Phone: 267-980-4822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00378700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC005786
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: