MEDICARE: LEE MICHAEL SWEENEY

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
1	101Y00000X	Counselor	0701015403	VA

General Provider Information

NPI Number	:	1396619011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE MICHAEL SWEENEY

Provider Business Mailing Address
First Line	:	4370 STARKEY RD STE 4D
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0603
Country	:	US
Telephone Number	:	540-772-8043
Fax Number	:

Provider Business Practice Location Address
First Line	:	4370 STARKEY RD STE 4D
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24018-0603
Country	:	US
Telephone Number	:	540-312-3877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2025
Last Update Date	:	10/13/2025

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