Sullivan, Paula Jo

Sullivan, Paula Jo is an sole proprietor health care provider with primary practice located at 2200 N Ponce De Leon Blvd Ste. 4, St Augustine FL 32084-2600. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Sullivan, Paula Jo can be contacted via phone (904) 806-6905.

Contact Information

Primary practice address
2200 N Ponce De Leon Blvd Ste. 4 St Augustine FL 32084-2600
Phone: (904) 806-6905
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW7316 Florida

Profile Details

NPI number 1538121488
LBN Legal business name Sullivan, Paula Jo
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 5th, 2006
Last updated Aug 7th, 2010 - about 14 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 1538121488 NPPES
Florida Other Z089R BLUE CROSS BLUE SHIELD

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