Healthcare Provider Details

I. General information

NPI: 1386847994
Provider Name (Legal Business Name): ERIN LYNNE SULLIVAN SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2007
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 COURT ST STE 3
CROMWELL CT
06416-1273
US

IV. Provider business mailing address

32 STONEYWOOD DR
NIANTIC CT
06357-1818
US

V. Phone/Fax

Practice location:
  • Phone: 860-613-9930
  • Fax: 860-613-9952
Mailing address:
  • Phone: 860-613-9930
  • Fax: 860-613-9952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number003851
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: