| Hannah Sullivan Llc | |
|
2828 Kraft Ave Se Grand Rapids MI 49512 | |
| (586) 943-3292 | |
| Not Available |
| Full Name | Hannah Sullivan Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2828 Kraft Ave Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Hannah Christine Sullivan (OWNER/THERAPIST) |
| Authorized Official Contact | 5869433292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hannah Sullivan Llc 1314 Calvin Ave Se Grand Rapids MI 49506-3212 Ph: (586) 943-3292 | Hannah Sullivan Llc 2828 Kraft Ave Se Grand Rapids MI 49512 Ph: (586) 943-3292 |
| NPI Number | 1225510753 |
|---|---|
| Provider Enumeration Date | 08/31/2018 |
| Last Update Date | 08/31/2018 |
| Medicare PECOS PAC ID | 3274887203 |
|---|---|
| Medicare Enrollment ID | O20181110000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225510753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801085815 (Michigan) | Primary |
| Provider Name | Hannah C Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407889967 PECOS PAC ID: 6901801919 Enrollment ID: I20060926000444 |
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