Evelyn Sullivan, is a
Social Worker based in Gulfport, Mississippi. Evelyn Sullivan is licensed to practice in Mississippi (license number M9417) and her current practice location is
1600 Broad Ave, Gulfport, Mississippi. She can be reached at her office (for appointments etc.) via phone at
(228) 865-1719.
NPI number for Evelyn Sullivan is 1659835908 and her current mailing address is 1600 Broad Ave, Gulfport, Mississippi. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1659835908.
Healthcare Provider's Profile
| Full Name | Evelyn Sullivan |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker |
|---|
| Location | 1600 Broad Ave, Gulfport, Mississippi |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1659835908
- Provider Enumeration Date: 01/30/2019
- Last Update Date: 07/03/2019
Medical Identifiers
Medical identifiers for Evelyn Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659835908 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | M9417 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evelyn Sullivan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Evelyn Sullivan,
1600 Broad Ave,
Gulfport, MS 39501-3603
Ph: (228) 865-1719 | Evelyn Sullivan,
1600 Broad Ave,
Gulfport, MS 39501-3603
Ph: (228) 865-1719 |
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