Individual
SHARLENE MARY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LDAC1
Contact information
Practice address
103 MYRON ST STE A, WEST SPRINGFIELD, MA 01089
(413) 592-1980
(413) 439-0100
Mailing address
103 MYRON ST STE A, WEST SPRINGFIELD, MA 01089-1485
(413) 592-1980
(413) 439-0100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
789
MA
Other
Enumeration date
03/30/2007
Last updated
08/17/2018
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