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NPI Code Detail

MEDICARE: MR. MATTHEW PHILIP SWEENEY MSW LICSW

MEDICARE: MR. MATTHEW PHILIP SWEENEY MSW 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 Worker116240MA

General Provider Information

NPI Number : 1508954215
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW PHILIP SWEENEY MSW LICSW
Provider Business Mailing Address
First Line : 66 HOMER AVE
Second Line : #110
City : CAMBRIDGE
State : MA
Zip : 02138-4500
Country : US
Telephone Number : 508-274-7326
Fax Number :
Provider Business Practice Location Address
First Line : 301 BROADWAY
Second Line :
City : CHELSEA
State : MA
Zip : 02150-2807
Country : US
Telephone Number : 857-776-7451
Fax Number : 857-776-7727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 03/14/2011

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