Charles Sullivan is a Clinical in Medford, Massachusetts. Charles Sullivan practices all healthcare services and medical treatments related to Clinical. The NPI Number for Charles Sullivan is 1114093259. The last update date is 2010-01-04.
Charles Sullivan's current location address is 10 High St Ste 10, Medford, Massachusetts. You can contact this provider via phone number 7813951560 and fax number 7813915564. The mailing address for Charles Sullivan is 10 High St Ste 10, Medford, Massachusetts. To know further, please read the information below!
Provider Profile Detail
Provider Name | Charles Sullivan |
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Address | 10 High St Ste 10, Medford, Massachusetts |
Phone Number | 7813951560 |
Fax Number | 7813915564 |
Sole Proprietor | Y |
Credentials | MSW, LICSW |
NPI Number Detail
NPI Number | 1114093259 |
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Provider Enumeration Date | 2006-11-28 |
Last Updated Date | 2010-01-04 |
Provider Mailing Address Detail
Address | 10 High St Ste 10 |
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City | Medford |
State | Massachusetts (MA) |
Post Code | 21553848 |
Phone Number | 7813951560 |
Fax Number | 7813915564 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 1041C0700X |
Licence No | 89.0060196 |
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 identifier code issued to Charles Sullivan by the Centers for Medicare & Medicaid Services (CMS)?
The Charles Sullivan has been assigned the NPI (National Provider Identifier) 1114093259. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Charles Sullivan's physical address?
The Charles Sullivan is physically located at 10 High St Ste 10, in the city of Medford, MA, with the postal code 21553848.
What is Charles Sullivan's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Charles Sullivan is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
On what date did the Charles Sullivan receive its 1114093259 assignment from the Centers for Medicare & Medicaid Services?
The Charles Sullivan was assigned its 1114093259 by the Centers for Medicare & Medicaid Services on 2006-11-28.
As of what date were the details related to Charles Sullivan most recently updated or revised?
The information pertaining to Charles Sullivan, including its address, specialty, and other relevant details, was last updated or revised on 2010-01-04.
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