MEDICARE: MATTHEW SWEENEY 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
1	1041C0700X	Clinical Social Worker	31238	MN

General Provider Information

NPI Number	:	1548057607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW SWEENEY LICSW

Provider Business Mailing Address
First Line	:	10 RIVER PARK PLZ STE 710
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55107-1223
Country	:	US
Telephone Number	:	651-224-0614
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 RIVER PARK PLZ STE 710
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55107-1223
Country	:	US
Telephone Number	:	651-224-0614
Fax Number	:

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

Provider Enumeration Date	:	04/22/2025
Last Update Date	:	04/22/2025

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