Provider Demographics
NPI:1992841431
Name:SWEENEY, NANCY M (PSYD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:M
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 PLEASANT ST
Mailing Address - Street 2:SUITE 28
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6535
Mailing Address - Country:US
Mailing Address - Phone:508-847-0999
Mailing Address - Fax:
Practice Address - Street 1:94 PLEASANT ST
Practice Address - Street 2:SUITE 28
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-6535
Practice Address - Country:US
Practice Address - Phone:508-847-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7208103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05610OtherBLUE CROSS
MA007208OtherTUFTS
MAW50204Medicare ID - Type Unspecified