Organization
NANCY A. SULLIVAN, LCSW
Active
Other names
Spectrum Clinical Services and Consulting LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY ANNE SULLIVAN LCSW (PRESIDENT)
(917) 751-5952
Entity
Organization
Contact information
Practice address
159-13 HORACE HARDING EXPRESSWAY, FRESH MEADOWS, NY 11365
(917) 751-5952
(718) 460-5488
Mailing address
159-13 HORACE HARDING EXPRESSWAY, FRESH MEADOWS, NY 11365
(917) 751-5952
(718) 460-5488
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
075477
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244019
—
NY
Enumeration date
07/30/2013
Last updated
07/30/2013
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