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NPI Code Detail

MEDICARE: SUSAN ELLIS SWEET LICSW

MEDICARE: SUSAN ELLIS SWEET LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerISW01216RI

General Provider Information

NPI Number : 1134141062
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ELLIS SWEET LICSW
Provider Business Mailing Address
First Line : 8545 DANBURY BLVD
Second Line : # 104
City : NAPLES
State : FL
Zip : 34120-0618
Country : US
Telephone Number : 239-384-9764
Fax Number :
Provider Business Practice Location Address
First Line : 6075 BATHEY LN
Second Line :
City : NAPLES
State : FL
Zip : 34116-7536
Country : US
Telephone Number : 239-455-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2006
Last Update Date : 02/15/2008

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Directions to “ SUSAN ELLIS SWEET LICSW” Practice Location

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