Mark Andrew Sullivan in Brockton - Clinical
Mark Andrew Sullivan - NPI 1790813509
Mark Andrew Sullivan is a Clinical in Brockton, Massachusetts. Mark Andrew Sullivan practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mark Andrew Sullivan is 1790813509. The last update date is 2007-07-08.
Mark Andrew Sullivan's current location address is 111 Torrey St, Brockton, Massachusetts. You can contact this provider via phone number 5085845190. The mailing address for Mark Andrew Sullivan is 111 Torrey St, Brockton, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Andrew Sullivan |
|---|---|
| Address | 111 Torrey St, Brockton, Massachusetts |
| Phone Number | 5085845190 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1790813509 |
|---|---|
| Provider Enumeration Date | 2007-03-01 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 111 Torrey St |
|---|---|
| City | Brockton |
| State | Massachusetts (MA) |
| Post Code | 23014800 |
| Phone Number | 5085845190 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 1020933 |
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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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What is the unique provider identifier assigned to Mark Andrew Sullivan?
The Mark Andrew Sullivan has been issued the NPI (National Provider Identifier) 1790813509 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Mark Andrew Sullivan?
The Mark Andrew Sullivan is situated at 111 Torrey St, in the city of Brockton, state of MA, with the zip code 23014800.
What is Mark Andrew Sullivan's area of expertise and its corresponding taxonomy classification?
The Mark Andrew 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 Mark Andrew Sullivan receive its 1790813509 assignment from the Centers for Medicare & Medicaid Services?
The Mark Andrew Sullivan was assigned its 1790813509 on 2007-03-01, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Mark Andrew Sullivan, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mark Andrew Sullivan, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.