Sullivan, Edward Mark
Sullivan, Edward Mark is an sole proprietor health care provider with primary practice located at 570 N State St Ste 220C , Westerville OH 43082-8086. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Sullivan, Edward Mark can be contacted via phone (614) 696-8400.Contact Information
Primary practice address
570 N State St Ste 220C
Westerville OH 43082-8086
Phone: (614) 696-8400
Fax: (614) 362-9909
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I0004577 | Ohio |
Profile Details
| NPI number | 1659407674 |
|---|---|
| LBN Legal business name | Sullivan, Edward Mark |
| Credentials | MSW, LISW-S |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Jun 3rd, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659407674 | NPPES |
| Ohio | MEDICAID | 0243763 | |
| Ohio | Other | PO1698877 | |
| Ohio | MEDICAID | 0041581 |
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