| Michael Sullivan, Msw, Inc. | |
|
304 Grand Ave Billings MT 59101 | |
| (406) 245-4566 | |
| (406) 245-2441 |
| Full Name | Michael Sullivan, Msw, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 304 Grand Ave, Billings, Montana |
| Authorized Official Name and Position | Diane Lynn Sullivan (BUSINESS MANAGER) |
| Authorized Official Contact | 4068616389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Sullivan, Msw, Inc. 304 Grand Ave Billings MT 59101-5923 Ph: (406) 861-6389 | Michael Sullivan, Msw, Inc. 304 Grand Ave Billings MT 59101 Ph: (406) 245-4566 |
| NPI Number | 1063567493 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 09/06/2018 |
| Medicare PECOS PAC ID | 7517908122 |
|---|---|
| Medicare Enrollment ID | O20050513000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063567493 | NPI | - | NPPES |
| 7082-0 | Other | MT | BCBS |
| A796094 | Other | MT | VALUE OPTIONS |
| 0501046 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 192 (Montana) | Primary |
| Provider Name | Michael D Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427240720 PECOS PAC ID: 2062452055 Enrollment ID: I20050510000203 |
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