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NPI Code Detail

MEDICARE: CORNELIA M SWEENEY PH.D.

MEDICARE: CORNELIA M SWEENEY PH.D.
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
1103T00000XPsychologistPY01634MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120538019OTHERBCBSKC INDIVIDUAL #
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770627408
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORNELIA M SWEENEY PH.D.
Provider Business Mailing Address
First Line : 222 W GREGORY BLVD
Second Line : SUITE 100
City : KANSAS CITY
State : MO
Zip : 64114-1140
Country : US
Telephone Number : 816-361-0664
Fax Number : 816-361-0677
Provider Business Practice Location Address
First Line : 222 W GREGORY BLVD
Second Line : SUITE 100
City : KANSAS CITY
State : MO
Zip : 64114-1140
Country : US
Telephone Number : 816-361-0664
Fax Number : 816-361-0677
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 09/24/2010

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