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General NPI Number Information
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NPI Number | 1497644694
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Entity Type | Organization
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Legal Business Name | MELISSA SULLIVAN, LICSW PC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 41 TAUNTON GRN STE 204
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City | TAUNTON
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State | MA
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Zip | 02780-3252
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Country | US
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Telephone | 508-386-3077
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CARMA LN
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City | BERKLEY
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State | MA
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Zip | 02779-1426
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Country | US
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Telephone | 508-954-2472
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MELISSA SULLIVAN
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Credential | MSW
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Telephone | 508-954-2472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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