Sullivan, Anthony Michael

Sullivan, Anthony Michael is an individual health care provider with primary practice located at 3225 Independence Rd , Canon City CO 81212-9380. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Sullivan, Anthony Michael can be contacted via phone (719) 275-2351.

Contact Information

Primary practice address
3225 Independence Rd Canon City CO 81212-9380
Phone: (719) 275-2351
Fax: (719) 269-9386
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2778 Colorado
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3490 Colorado

Profile Details

NPI number 1245362615
LBN Legal business name Sullivan, Anthony Michael
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 12th, 2007
Last updated Jul 29th, 2020 - about 5 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 1245362615 NPPES
Colorado MEDICAID 26350246

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