| Michael Sullivan Counseling Pc | |
|
110 N 37th St Ste 301 Norfolk NE 68701-3283 | |
| (402) 750-7923 | |
| Not Available |
| Full Name | Michael Sullivan Counseling Pc |
|---|---|
| Speciality | Counselor |
| Location | 110 N 37th St Ste 301, Norfolk, Nebraska |
| Authorized Official Name and Position | Michael Daniel Sullivan (PRESIDENT) |
| Authorized Official Contact | 4027507923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Sullivan Counseling Pc 110 N 37th St Ste 301 Norfolk NE 68701-3283 Ph: (402) 750-7923 | Michael Sullivan Counseling Pc 110 N 37th St Ste 301 Norfolk NE 68701-3283 Ph: (402) 750-7923 |
| NPI Number | 1568615128 |
|---|---|
| Provider Enumeration Date | 10/28/2008 |
| Last Update Date | 10/13/2023 |
| Certification Date | 10/13/2023 |
| Medicare PECOS PAC ID | 4486812047 |
|---|---|
| Medicare Enrollment ID | O20120228000702 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568615128 | NPI | - | NPPES |
| 10026181901 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1464 (Nebraska) | Primary |
| Provider Name | Michael D Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063548139 PECOS PAC ID: 9739347394 Enrollment ID: I20120229000373 |
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