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General NPI Number Information
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NPI Number | 1376643288
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Entity Type | Organization
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Legal Business Name | TIMOTHY J. SWEENEY, P.C.
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 11244 WAPLES MILL RD SUITE K
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City | FAIRFAX
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State | VA
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Zip | 22030-6040
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Country | US
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Telephone | 703-359-4848
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Fax | 703-991-9130
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Provider Business Mailing Address
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Address Line | 11244 WAPLES MILL RD SUITE K
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City | FAIRFAX
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State | VA
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Zip | 22030-6040
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Country | US
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Telephone | 703-359-4848
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Fax | 703-991-9130
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TIMOTHY JOHN SWEENEY
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Credential | LCSW
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Telephone | 703-359-4848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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