Provider Demographics
NPI:1194494310
Name:SWEET, KRISTIN MARY DOMBROWSKI (LMSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARY DOMBROWSKI
Last Name:SWEET
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5289 BEAR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-7213
Mailing Address - Country:US
Mailing Address - Phone:517-652-5715
Mailing Address - Fax:
Practice Address - Street 1:1921 E MILLER RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-5348
Practice Address - Country:US
Practice Address - Phone:517-319-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011091771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical