| Brandi Sullivan Lcsw Llc | |
|
4440 Fort Shaw Dr New Port Richey FL 34655-7314 | |
| (813) 751-4804 | |
| Not Available |
| Full Name | Brandi Sullivan Lcsw Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4440 Fort Shaw Dr, New Port Richey, Florida |
| Authorized Official Name and Position | Brandi Sullivan (OWNER) |
| Authorized Official Contact | 8137514804 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandi Sullivan Lcsw Llc 4440 Fort Shaw Dr New Port Richey FL 34655-7314 Ph: (813) 751-4804 | Brandi Sullivan Lcsw Llc 4440 Fort Shaw Dr New Port Richey FL 34655-7314 Ph: (813) 751-4804 |
| NPI Number | 1023764479 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 09/03/2024 |
| Certification Date | 09/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023764479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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