Sullivan, Melinda Baskin

Sullivan, Melinda Baskin is an sole proprietor health care provider with primary practice located at 910 S. 8Th Street, Suite 124 , Fernandina Beach FL 32034-2250. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Sullivan, Melinda Baskin can be contacted via phone (904) 557-1006.

Contact Information

Primary practice address
910 S. 8Th Street, Suite 124 Fernandina Beach FL 32034-2250
Phone: (904) 557-1006
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH10362 Florida

Profile Details

NPI number 1033428461
LBN Legal business name Sullivan, Melinda Baskin
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2010
Last updated Feb 22nd, 2018 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1033428461 NPPES
Florida Other 12196399 CAQH
Florida MEDICAID 002775800 CAQH

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