1972606556 NPI number — MS. CECELIA A SWEENEY LCSW CASAC

Table of content: MS. CECELIA A SWEENEY LCSW CASAC (NPI 1972606556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972606556 NPI number — MS. CECELIA A SWEENEY LCSW CASAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SWEENEY
Provider First Name:
CECELIA
Provider Middle Name:
A
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW CASAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972606556
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
39 W WILLOW ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-581-2199
Provider Business Mailing Address Fax Number:
631-581-1942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
39 W WILLOW ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-581-2199
Provider Business Practice Location Address Fax Number:
631-581-1942
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  1331 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X , with the licence number: R035580 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0004292346 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: N3353 . This is a "EMPIRE BLUE CROSS BLUE SH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2718OR271384 . This is a "MHN SERVICES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0004292346 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01969451 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P33626623 . This is a "MULTIPLAN INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: S7564 . This is a "APS PROVIDER HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 223760 . This is a "OPTUM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 45029 . This is a "VYTRA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9529700 . This is a "EMPIRE STATE CARPENTERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2269757 . This is a "AETNA HEALTH MANAGEMENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7400635 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 93929 . This is a "NATIONAL BENEFIT FUND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 93593 . This is a "MAGELLAN BEHAVIORAL HEALT" identifier . This identifiers is of the category "OTHER".
  • Identifier: P1895303 . This is a "OXFORD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".




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