Individual
BRIAN J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS LPC
Contact information
Practice address
6717 STONE GLEN DRIVE, MIDDLETON, WI 53562
(608) 827-7100
(608) 827-7101
Mailing address
6717 STONE GLEN DRIVE, MIDDLETON, WI 53562
(608) 827-7100
(608) 827-7101
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3155125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39782800
—
WI
Enumeration date
04/24/2008
Last updated
04/24/2008
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