Individual
MR. JAMES M SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW #114273
Contact information
Practice address
28 OCEAN HILL DR, KINGSTON, MA 02334
(617) 910-6078
(617) 275-8772
Mailing address
28 OCEAN HILL DR, KINGSTON, MA 02334
(617) 910-6078
(617) 275-8772
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
114273
MA
101YM0800X
Mental Health Counselor
114273
MA
104100000X
Social Worker
213178
MA
Other
Enumeration date
09/20/2006
Last updated
10/30/2012
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