Hanson, Mark Sullivan

Hanson, Mark Sullivan is an sole proprietor health care provider with primary practice located at 130 Centre St Wadsworth Village, Hathorne House #4, Danvers MA 01923-1400. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Hanson, Mark Sullivan can be contacted via phone (978) 777-1088.

Contact Information

Primary practice address
130 Centre St Wadsworth Village, Hathorne House #4 Danvers MA 01923-1400
Phone: (978) 777-1088
Fax: (978) 777-3883
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6390 Massachusetts

Profile Details

NPI number 1003984386
LBN Legal business name Hanson, Mark Sullivan
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 2nd, 2006
Last updated May 24th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003984386 NPPES
Massachusetts Other W06514 BLUE CROSS BLUE SHIELD

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