Individual
MRS. MELISSA A SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1500
Mailing address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1284
(401) 432-1509
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW02056
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MS81200
—
RI
Enumeration date
03/25/2007
Last updated
04/12/2012
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