Healthcare Provider Details

I. General information

NPI: 1497395487
Provider Name (Legal Business Name): ERIN SWEENEY PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2020
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 WATERMAN ST STE 200
PROVIDENCE RI
02906-5215
US

IV. Provider business mailing address

58 KINGSTOWN RD
NARRAGANSETT RI
02882-3342
US

V. Phone/Fax

Practice location:
  • Phone: 401-351-7779
  • Fax: 401-351-8188
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS01829
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: