Provider Demographics
NPI:1992997605
Name:SWEET, BRUCE H (MA, LLP, LMSW)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:H
Last Name:SWEET
Suffix:
Gender:M
Credentials:MA, LLP, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ORLEANS BLVD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1767
Mailing Address - Country:US
Mailing Address - Phone:517-279-8404
Mailing Address - Fax:517-279-8172
Practice Address - Street 1:200 ORLEANS BLVD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-1767
Practice Address - Country:US
Practice Address - Phone:517-279-8404
Practice Address - Fax:517-279-8172
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006084103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist