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Individual

MISS LINDSEY ANN SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW,BA

Contact information

Practice address
141 E MAIN ST, 3RD FLOOR HOME BASED SERVICES, WATERBURY, CT 06702-2310
(203) 575-0466
(203) 575-1817
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041S0200X
School Social Worker
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
013
CONNECTICUT STATE DEPT OF EDUCATION-KINDERGARTEN THRU 6TH GRADE ELEMENTARY
CT
01
071
CONNECTICUT STATE DEPT OF EDUCATION-SCHOOL SOCIAL WORKER
CT
Enumeration date
09/18/2013
Last updated
03/13/2017
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