Individual
MS. KATHLEEN ELLEN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
16 LINCOLN ST., SUITE C, BRUNSWICK, ME 04032
(207) 400-2454
Mailing address
P.O. BOX 523, FREEPORT, ME 04032
(207) 865-6695
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
#469
ME
1041C0700X
Clinical Social Worker
LC469
ME
Other
Enumeration date
09/15/2006
Last updated
10/20/2015
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