Sullivan, Richard
Sullivan, Richard is an individual health care provider with primary practice located at 7920 Old Cedar Ave S , Bloomington MN 55425-1207. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Sullivan, Richard can be contacted via phone (952) 851-1000.Contact Information
Primary practice address
7920 Old Cedar Ave S
Bloomington MN 55425-1207
Phone: (952) 851-1000
Fax: (952) 851-1092
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | LP4326 | Minnesota |
Profile Details
| NPI number | 1912932468 |
|---|---|
| LBN Legal business name | Sullivan, Richard |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Mar 11th, 2021 - about 3 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 | 1912932468 | NPPES |
| Minnesota | MEDICAID | 459093700 |
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