=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164109120
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SWEENEY PSYCHOTHERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2023
-----------------------------------------------------
Last Update Date | 03/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 REGENCY VILLAGE WAY APT 307
-----------------------------------------------------
City | MERRIMAC
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01860-2507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-518-9270
-----------------------------------------------------
Fax | 508-433-1871
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 REGENCY VILLAGE WAY APT 307
-----------------------------------------------------
City | MERRIMAC
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01860-2507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-518-9270
-----------------------------------------------------
Fax | 508-433-1871
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PATRICIA SWEENEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 978-518-9270
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------