Organization
MICHAEL SULLIVAN, MSW, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE LYNN SULLIVAN (BUSINESS MANAGER)
(406) 861-6389
Entity
Organization
Contact information
Practice address
304 GRAND AVE, BILLINGS, MT 59101
(406) 245-4566
(406) 245-2441
Mailing address
304 GRAND AVE, BILLINGS, MT 59101-5923
(406) 861-6389
(406) 245-2441
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
192
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0501046
—
MT
01
—
7082-0
BCBS
MT
01
—
A796094
VALUE OPTIONS
MT
Enumeration date
01/24/2007
Last updated
09/06/2018
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