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General NPI Number Information
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NPI Number | 1194586404
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Entity Type | Individual
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Provider Name | MS. CAITLIN SULLIVAN
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Gender | Female
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 900 SHIP POND RD
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City | PLYMOUTH
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State | MA
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Zip | 02360-1849
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Country | US
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Telephone | 781-361-0685
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Fax |
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Provider Business Mailing Address
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Address Line | 401 COUNTRY CLUB WAY
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City | KINGSTON
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State | MA
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Zip | 02364-4108
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Country | US
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Telephone | 781-361-0685
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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