Sullivan, Ellen J
Sullivan, Ellen J is an individual health care provider with primary practice located at 10 Tower Dr , Sun Prairie WI 53590-1239. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Sullivan, Ellen J can be contacted via phone (608) 825-3500.Contact Information
Primary practice address
10 Tower Dr
Sun Prairie WI 53590-1239
Phone: (608) 825-3500
Fax: (608) 825-3794
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 6903-123 | Wisconsin |
Profile Details
| NPI number | 1861459760 |
|---|---|
| LBN Legal business name | Sullivan, Ellen J |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2006 |
| Last updated | Dec 28th, 2020 - about 6 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 | 1861459760 | NPPES |
| Wisconsin | MEDICAID | 1861459760 |
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