Sullivan, Brian J
Sullivan, Brian J is an individual health care provider with primary practice located at 6717 Stone Glen Drive , Middleton WI 53562. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Sullivan, Brian J can be contacted via phone (608) 827-7100.Contact Information
Primary practice address
6717 Stone Glen Drive
Middleton WI 53562
Phone: (608) 827-7100
Fax: (608) 827-7101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 3155125 | Wisconsin |
Profile Details
| NPI number | 1619142312 |
|---|---|
| LBN Legal business name | Sullivan, Brian J |
| Credentials | MS LPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 24th, 2008 |
| Last updated | Apr 24th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619142312 | NPPES |
| Wisconsin | MEDICAID | 39782800 |
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