Individual
JEANINE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
61 BRADLEY ST, BRISTOL, CT 06010-5103
(860) 677-5967
Mailing address
27 WELLINGTON DR, FARMINGTON, CT 06032-3207
(860) 677-5967
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000414
CT
1041C0700X
Clinical Social Worker
003583
CT
Other
Enumeration date
02/05/2007
Last updated
09/11/2025
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