Healthcare Provider Details

I. General information

NPI: 1285102673
Provider Name (Legal Business Name): CHELSIE THERESA SWEENEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2749 N WEIL ST
MILWAUKEE WI
53212-2617
US

IV. Provider business mailing address

2749 N WEIL ST
MILWAUKEE WI
53212-2617
US

V. Phone/Fax

Practice location:
  • Phone: 414-207-4799
  • Fax:
Mailing address:
  • Phone: 414-207-4799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11188
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11188
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: