Individual
MICHAEL ROBERT SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60648868
WA
104100000X
Social Worker
Primary
LW61234841
WA
104100000X
Social Worker
SC61158375
WA
1041C0700X
Clinical Social Worker
LW61234841
WA
Other
Enumeration date
10/21/2015
Last updated
04/22/2022
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