Sullivan, Victoria
Sullivan, Victoria is an individual health care provider with primary practice located at 677 State Route 17M , Monroe NY 10950-3318. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Sullivan, Victoria can be contacted via phone (845) 618-5242.Contact Information
Primary practice address
677 State Route 17M
Monroe NY 10950-3318
Phone: (845) 618-5242
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | R075421-1 | New York |
Profile Details
| NPI number | 1750400677 |
|---|---|
| LBN Legal business name | Sullivan, Victoria |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2007 |
| Last updated | Apr 17th, 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 | 1750400677 | NPPES |
| New York | MEDICAID | 04325182 |
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