Individual
ASHLEY NICOLE N NEAL SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
306 NICODEMUS RD, GLYNDON, MD 21136-3229
(703) 371-8744
Mailing address
306 NICODEMUS RD, GLYNDON, MD 21136-3229
(703) 371-8744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904008153
VA
1041C0700X
Clinical Social Worker
Primary
26412
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04945247
—
VA
Enumeration date
05/31/2013
Last updated
04/25/2021
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