Individual
MICHAEL DANIEL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW, CDGC
Contact information
Practice address
110 N 37TH ST STE 301, NORFOLK, NE 68701-3283
(402) 750-7923
Mailing address
110 N 37TH ST STE 301, NORFOLK, NE 68701-3283
(402) 750-7923
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1464
NE
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
077785
VALUE OPTIONS
NE
01
—
082537
BLUE CROSS
NE
01
—
299363000
MAGELLAN MIS
NE
01
—
8721
MIDLANDS CHOICE
NE
Enumeration date
02/25/2007
Last updated
04/08/2025
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