Mary M Sullivan is a Clinical in Cos Cob, Connecticut. Mary M Sullivan practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary M Sullivan is 1174551030. The last update date is 2011-06-06.
Mary M Sullivan's current location address is 132 E Putnam Ave, Cos Cob, Connecticut. You can contact this provider via phone number 2039622209 and fax number 2039622209. The mailing address for Mary M Sullivan is 132 E Putnam Ave, Cos Cob, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary M Sullivan |
|---|---|
| Address | 132 E Putnam Ave, Cos Cob, Connecticut |
| Phone Number | 2039622209 |
| Fax Number | 2039622209 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1174551030 |
|---|---|
| Provider Enumeration Date | 2006-06-29 |
| Last Updated Date | 2011-06-06 |
Provider Mailing Address Detail
| Address | 132 E Putnam Ave |
|---|---|
| City | Cos Cob |
| State | Connecticut (CT) |
| Post Code | 68072744 |
| Phone Number | 2039622209 |
| Fax Number | 2039622209 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 5814 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4172920 | CT | -- | |
| 4172912 | CT | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Mary M Sullivan by the Centers for Medicare & Medicaid Services?
The Mary M Sullivan has been issued the NPI (National Provider Identifier) 1174551030, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Mary M Sullivan's facilities are situated?
The facilities of Mary M Sullivan are physically located at the following address: 132 E Putnam Ave, Cos Cob, CT, 68072744.
What is Mary M Sullivan's area of expertise and its corresponding taxonomy classification?
The Mary M Sullivan's field of specialization is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Mary M Sullivan receive the assignment of its 1174551030 from the Centers for Medicare & Medicaid Services?
The Mary M Sullivan was issued its 1174551030 by the Centers for Medicare & Medicaid Services on 2006-06-29.
As of what date was the information pertaining to Mary M Sullivan, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Mary M Sullivan, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2011-06-06.