Sullivan, Paula A
Sullivan, Paula A is an individual health care provider with primary practice located at 1002 Wishard Blvd Ste 2120 , Indianapolis IN 46202-2872. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Sullivan, Paula A can be contacted via phone (317) 944-8162.Contact Information
Primary practice address
1002 Wishard Blvd Ste 2120
Indianapolis IN 46202-2872
Phone: (317) 944-8162
Fax: (317) 944-9760
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 20040129 | Indiana |
Profile Details
| NPI number | 1811000169 |
|---|---|
| LBN Legal business name | Sullivan, Paula A |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 17th, 2006 |
| Last updated | Nov 20th, 2020 - about 4 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 | 1811000169 | NPPES |
| Indiana | MEDICAID | 100218710 |
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