Healthcare Provider Details

I. General information

NPI: 1073808093
Provider Name (Legal Business Name): MEAGHAN SULLIVAN MSW, CSAC, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 EMORY ST
ATTLEBORO MA
02703-2435
US

IV. Provider business mailing address

127 EMORY ST
ATTLEBORO MA
02703-2435
US

V. Phone/Fax

Practice location:
  • Phone: 508-851-4308
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberISW04911
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: