Provider Demographics
NPI:1972606556
Name:SWEENEY, CECELIA A (LCSW CASAC)
Entity type:Individual
Prefix:MS
First Name:CECELIA
Middle Name:A
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:LCSW CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 W WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717
Mailing Address - Country:US
Mailing Address - Phone:631-581-2199
Mailing Address - Fax:631-581-1942
Practice Address - Street 1:39 W WILLOW ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717
Practice Address - Country:US
Practice Address - Phone:631-581-2199
Practice Address - Fax:631-581-1942
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1331101YA0400X
NYR0355801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0004292346OtherAETNA US HEALTHCARE
N3353OtherEMPIRE BLUE CROSS BLUE SH
2718OR271384OtherMHN SERVICES
0004292346OtherAETNA
NY01969451Medicaid
P33626623OtherMULTIPLAN INSURANCE
S7564OtherAPS PROVIDER HEALTHCARE
223760OtherOPTUM
45029OtherVYTRA HEALTH PLAN
9529700OtherEMPIRE STATE CARPENTERS
2269757OtherAETNA HEALTH MANAGEMENT
7400635OtherGHI
93929OtherNATIONAL BENEFIT FUND
93593OtherMAGELLAN BEHAVIORAL HEALT
P1895303OtherOXFORD HEALTH PLAN
NYN33531Medicare ID - Type Unspecified