Healthcare Provider Details

I. General information

NPI: 1871401810
Provider Name (Legal Business Name): CATHERINE SULLIVAN-KONYN MSW, APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E BURLEIGH ST
MILWAUKEE WI
53212-2217
US

IV. Provider business mailing address

5757 W OKLAHOMA AVE STE 203
MILWAUKEE WI
53219-4303
US

V. Phone/Fax

Practice location:
  • Phone: 414-267-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: