| Nancy A Sullivan, Lcsw Pllc | |
|
159-13 Horace Harding Expwy Fresh Meadows NY 11365-1424 | |
| (917) 751-5952 | |
| (718) 460-5488 |
| Full Name | Nancy A Sullivan, Lcsw Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 159-13 Horace Harding Expwy, Fresh Meadows, New York |
| Authorized Official Name and Position | Nancy A Sullivan (OWNER SOLE PROPRIETOR) |
| Authorized Official Contact | 9177515952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nancy A Sullivan, Lcsw Pllc 159-13 Horace Harding Expwy Fresh Meadows NY 11365-1424 Ph: (917) 751-5952 | Nancy A Sullivan, Lcsw Pllc 159-13 Horace Harding Expwy Fresh Meadows NY 11365-1424 Ph: (917) 751-5952 |
| NPI Number | 1144937160 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 03/02/2023 |
| Certification Date | 03/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144937160 | NPI | - | NPPES |
| 03887285 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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