Sullivan, Jeanine

Sullivan, Jeanine is an sole proprietor health care provider with primary practice located at 61 Bradley St , Bristol CT 06010-5103. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Sullivan, Jeanine can be contacted via phone (860) 677-5967.

Contact Information

Primary practice address
61 Bradley St Bristol CT 06010-5103
Phone: (860) 677-5967
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 000414 Connecticut
Behavioral Health & Social Service Providers / Clinical 1041C0700X 003583 Connecticut

Profile Details

NPI number 1437298726
LBN Legal business name Sullivan, Jeanine
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 5th, 2007
Last updated Jul 8th, 2007 - about 19 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.

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