Sullivan, Mary M
Sullivan, Mary M is an sole proprietor health care provider with primary practice located at 132 E Putnam Ave Suite H, Cos Cob CT 06807-2744. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Sullivan, Mary M can be contacted via phone (203) 962-2209.Contact Information
Primary practice address
132 E Putnam Ave Suite H
Cos Cob CT 06807-2744
Phone: (203) 962-2209
Fax: (203) 962-2209
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 005814 | Connecticut |
Profile Details
| NPI number | 1174551030 |
|---|---|
| LBN Legal business name | Sullivan, Mary M |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 29th, 2006 |
| Last updated | Jun 6th, 2011 - about 13 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 | 1174551030 | NPPES |
| Connecticut | MEDICAID | 004172920 | |
| Connecticut | MEDICAID | 004172912 |
Popular Providers
-
Druker, Lisa K
132 E Putnam Ave # 2E , Cos Cob CT 06807-2744 -
Loomis, James F.
1398 Palmetto Dr , Portage MI 49002-3923 -
Foster, Lindsey Ac
10 Elm St , Cos Cob CT 06807-1605 -
Pagano, Patricia L.
46 Mianus View Ter , Cos Cob CT 06807-2218 -
Nevins, Lori Sperling
28A Butler St , Cos Cob CT 06807-2610 -
Aveni, James Vincent
901 Wallace Blvd Bldg 501, Amarillo TX 79106-1705 -
Lloyd, Tangley Canpbell
132 E Putnam Ave , Cos Cob CT 06807 -
Grant, John H.
291 Wall St. , Kingston NY 12401-3849