| Glenn R. Sullivan, Ph.d. | |
|
30 Crossing Ln Ste 101 Lexington VA 24450 | |
| (540) 463-2080 | |
| (540) 464-7648 |
| Full Name | Glenn R. Sullivan, Ph.d. |
|---|---|
| Speciality | Psychologist |
| Location | 30 Crossing Ln Ste 101, Lexington, Virginia |
| Authorized Official Name and Position | Glenn R. Sullivan (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5404632080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn R. Sullivan, Ph.d. 106 Colston Pl Lexington VA 24450-1812 Ph: (540) 463-2080 | Glenn R. Sullivan, Ph.d. 30 Crossing Ln Ste 101 Lexington VA 24450 Ph: (540) 463-2080 |
| NPI Number | 1992209720 |
|---|---|
| Provider Enumeration Date | 03/19/2018 |
| Last Update Date | 05/17/2018 |
| Medicare PECOS PAC ID | 4880958032 |
|---|---|
| Medicare Enrollment ID | O20180516000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992209720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810003867 (Virginia) | Primary |
| Provider Name | Glenn R Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871764779 PECOS PAC ID: 0648331025 Enrollment ID: I20081203000678 |
Acts, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 N Lee Hwy, Building 20, Suite 4, Lexington, VA 24450 Phone: 540-526-4673 | |
Maple Hall Academy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3111 N Lee Hwy, Lexington, VA 24450 Phone: 540-463-6693 | |
Family Preservation Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Pendelton Pl, Lexington, VA 24450 Phone: 540-248-5510 Fax: 540-248-5509 | |
The Rockbridge Wellness Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 S Randolph St, Lexington, VA 24450 Phone: 540-572-0667 | |
Benjamin Pumphrey Md Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 W Nelson St, Lexington, VA 24450 Phone: 267-357-4186 | |
Strategic Therapy Associates, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 S Main St Ste 217, Lexington, VA 24450 Phone: 434-237-9450 Fax: 434-237-9454 | |
Rockbridge Area Community Services Board Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 241 Greenhouse Rd, Lexington, VA 24450 Phone: 540-463-3141 Fax: 540-462-6716 |