Provider Demographics
NPI:1063527778
Name:SWEENEY, CAROLYN M (LMFT)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3670
Mailing Address - Country:US
Mailing Address - Phone:203-315-1057
Mailing Address - Fax:203-315-4065
Practice Address - Street 1:678 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3670
Practice Address - Country:US
Practice Address - Phone:203-315-1057
Practice Address - Fax:203-315-4065
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000741106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist