Doctor Name: | DENNIS SWEENEY |
NPI Number: | 1174769897 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC, CADC II |
License Number: | C-2224 |
Business Practice Address: | 880 82nd Dr Western Psychological And Counseling Services Gladstone, OR - 970271803 |
Business Phone Number: | 5036595515 |
Business Fax Number: | 5032102475 |
Mailing Address: | Po Box 82819, PORTLAND |
State: | OR |
Postal Code: | 972820819 |
Phone Number: | 5032335405 |
Fax Number: | |
NPI Enumeration Date: | 12/30/2008 |
NPI Last Update Date: | 06/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C-2224 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |