Kenna Marie Sullivan in Brighton - Clinical
Kenna Marie Sullivan - NPI 1942410402
Kenna Marie Sullivan is a Clinical in Brighton, Massachusetts. Kenna Marie Sullivan practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenna Marie Sullivan is 1942410402. The last update date is 2007-07-08.
Kenna Marie Sullivan's current location address is 692 Washington St, Brighton, Massachusetts. You can contact this provider via phone number 6173128067 and fax number 6172549479. The mailing address for Kenna Marie Sullivan is 692 Washington St, Brighton, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenna Marie Sullivan |
|---|---|
| Address | 692 Washington St, Brighton, Massachusetts |
| Phone Number | 6173128067 |
| Fax Number | 6172549479 |
| Sole Proprietor | Y |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1942410402 |
|---|---|
| Provider Enumeration Date | 2007-05-23 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 692 Washington St |
|---|---|
| City | Brighton |
| State | Massachusetts (MA) |
| Post Code | 21351537 |
| Phone Number | 6173128067 |
| Fax Number | 6172549479 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 107098 |
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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 |
|---|---|---|---|
| 62-00541 | MA | EVERCARE | |
| 1854526 | MA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Kenna Marie Sullivan by the Centers for Medicare & Medicaid Services?
The Kenna Marie Sullivan has been assigned the NPI (National Provider Identifier) 1942410402 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Kenna Marie Sullivan located?
The Kenna Marie Sullivan is located at 692 Washington St, Brighton, MA 21351537.
What is Kenna Marie Sullivan's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kenna Marie Sullivan's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1942410402 to Kenna Marie Sullivan?
The Centers for Medicare & Medicaid Services assigned the 1942410402 to Kenna Marie Sullivan on 2007-05-23.
As of what date was the information regarding Kenna Marie Sullivan, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Kenna Marie Sullivan, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.