Provider Demographics
NPI:1730561226
Name:SWEENEY, CAROLYN ROSE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ROSE
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:ROSE
Other - Last Name:CALABRESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MC CFY-SLP
Mailing Address - Street 1:141 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-1933
Mailing Address - Country:US
Mailing Address - Phone:919-264-7985
Mailing Address - Fax:
Practice Address - Street 1:141 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1933
Practice Address - Country:US
Practice Address - Phone:919-264-7985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11895235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist