Jeanine Sullivan, LCSW is a
Social Worker - Clinical based in Bristol, Connecticut. Jeanine Sullivan is licensed to practice in Connecticut (license number 003583) and her current practice location is
61 Bradley St, Bristol, Connecticut. She can be reached at her office (for appointments etc.) via phone at
(860) 677-5967.
NPI number for Jeanine Sullivan is 1437298726 and her current mailing address is 27 Wellington Dr, Farmington, Connecticut. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1437298726.
Healthcare Provider's Profile
| Full Name | Jeanine Sullivan |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
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| Location | 61 Bradley St, Bristol, Connecticut |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1437298726
- Provider Enumeration Date: 02/05/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Jeanine Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1437298726 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 000414 (Connecticut) | Primary |
| 1041C0700X | Social Worker - Clinical | 003583 (Connecticut) | 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. Jeanine 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 |
|---|
Jeanine Sullivan, LCSW
27 Wellington Dr,
Farmington, CT 06032-3207
Ph: (860) 677-5967 | Jeanine Sullivan, LCSW
61 Bradley St,
Bristol, CT 06010-5103
Ph: (860) 677-5967 |
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