Individual
MS. ELAINE MARIE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
100 ERDMAN WAY, LEOMINSTER, MA 01453-1804
(978) 466-8364
(978) 345-6577
Mailing address
100 ERDMAN WAY, LEOMINSTER, MA 01453-0321
(978) 466-8364
(978) 345-6577
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1016700
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52852
—
MA
Enumeration date
10/21/2008
Last updated
10/21/2008
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