Provider Demographics
NPI:1548516115
Name:MICHAEL L. SWEENEY,MSW,P.C.
Entity type:Organization
Organization Name:MICHAEL L. SWEENEY,MSW,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:623-334-9700
Mailing Address - Street 1:18555 N 79TH AVE
Mailing Address - Street 2:SUITE B-103
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8370
Mailing Address - Country:US
Mailing Address - Phone:623-334-9700
Mailing Address - Fax:623-334-9728
Practice Address - Street 1:18555 N 79TH AVE
Practice Address - Street 2:SUITE B-103
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8370
Practice Address - Country:US
Practice Address - Phone:623-334-9700
Practice Address - Fax:623-334-9728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW04871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty