Sullivan, Meredith

Sullivan, Meredith is an sole proprietor health care provider with primary practice located at 2901 Hunters Trl , Portage WI 53901-3403. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Sullivan, Meredith can be contacted via phone (608) 742-5518.

Contact Information

Primary practice address
2901 Hunters Trl Portage WI 53901-3403
Phone: (608) 742-5518
Fax: (608) 742-4087
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 327-228 Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1047 Wisconsin

Profile Details

NPI number 1376944504
LBN Legal business name Sullivan, Meredith
Credentials MS, MA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2014
Last updated Sep 26th, 2016 - about 10 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 1376944504 NPPES
Wisconsin MEDICAID 1376944504

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