Mark Sullivan Llc | |
8703 Milford Ave Silver Spring MD 20910-5030 | |
(202) 264-0070 | |
Not Available |
Full Name | Mark Sullivan Llc |
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Speciality | Social Worker |
Location | 8703 Milford Ave, Silver Spring, Maryland |
Authorized Official Name and Position | Mark J Sullivan (CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 2022640070 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mark Sullivan Llc 8703 Milford Ave Silver Spring MD 20910-5030 Ph: (202) 264-0070 | Mark Sullivan Llc 8703 Milford Ave Silver Spring MD 20910-5030 Ph: (202) 264-0070 |
NPI Number | 1710470711 |
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Provider Enumeration Date | 06/13/2018 |
Last Update Date | 03/07/2024 |
Certification Date | 03/07/2024 |
Medicare PECOS PAC ID | 8628328630 |
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Medicare Enrollment ID | O20180912000235 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710470711 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LC50079401 (District Of Columbia) | Primary |
Provider Name | Mark Sullivan |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1346614641 PECOS PAC ID: 9537419544 Enrollment ID: I20180912000350 |
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