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General NPI Number Information
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NPI Number | 1992156426
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Entity Type | Individual
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Provider Name | THOMAS PATRICK SULLIVAN LMHC
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Gender | Male
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 30 WALPOLE STREET
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City | NORWOOD
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State | MA
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Zip | 02062-3356
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Country | US
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Telephone | 508-667-8839
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Fax |
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Provider Business Mailing Address
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Address Line | 30 WALPOLE ST
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City | NORWOOD
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State | MA
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Zip | 02062-3356
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Country | US
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Telephone | 508-667-8839
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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 | 9655
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License Number State | MA
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