Individual
ELLEN J SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3500
(608) 825-3794
Mailing address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3500
(608) 825-3794
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6903-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861459760
—
WI
Enumeration date
04/26/2006
Last updated
12/28/2020
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