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General NPI Number Information
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NPI Number | 1205377439
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Entity Type | Individual
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Provider Name | KATHLEEN SWEENEY MA LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 2425 E SOUTHLAKE BLVD SUITE 100
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6674
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Country | US
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Telephone | 817-600-4129
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Fax |
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Provider Business Mailing Address
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Address Line | 6114 MUSTANG TRL
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City | COLLEYVILLE
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State | TX
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Zip | 76034-7648
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Country | US
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Telephone | 817-600-2149
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 201657
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT41607
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License Number State | CA
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