Individual provider Active NPI

Athalyn Kelly Sweeney, LICSW

  • Clinical Social Worker
  • Nantucket, MA
National Provider Identifier
1720389836
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111913 Issued in MA
Practice address
20 Vesper LN
Nantucket, MA 02554-4394
Phone
(508) 228-2689
Fax
(508) 325-3613
NPI assigned
Nov 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 111913 MA Primary

Addresses

Primary practice location

20 Vesper LN
Nantucket, MA 02554-4394

Mailing address

20 Vesper LN
Nantucket, MA 02554-4394
Phone (508) 228-2689

Other names 1

  • Mrs. Athalyn Kelly Tobias Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111913MAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1720389836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 VESPER LN",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544394",
            "telephone_number": "508-228-2689",
            "fax_number": "508-325-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 VESPER LN",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544394",
            "telephone_number": "508-228-2689",
            "fax_number": "508-325-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "ATHALYN",
        "middle_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ATHALYN",
            "last_name": "TOBIAS",
            "middle_name": "KELLY",
            "prefix": "MRS.",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nantucket, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.