Individual
ANN L SULLIVAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
630 PLANTATION ST, WORCESTER, MA 01605
(508) 595-2041
(508) 853-7149
Mailing address
630 PLANTATION ST, WOT 12TH FLOOR ATTN PHYSICIAN SERVICES, WORCESTER, MA 01605
(508) 852-5529
(508) 368-5530
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
208779
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04247226
ONE HEALTH PLAN
—
01
—
042472266008
TRICARE CHAMPUS
—
01
—
2044474
FIRST HEALTH
—
01
—
2172099
CIGNA HEALTH PLAN
—
01
—
34530
FALLON COMMUNITY HEALTH P
—
01
—
788379
MVP HEALTH CARE
—
01
—
P22719
MEDICARE B
—
Enumeration date
01/04/2006
Last updated
07/08/2007
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