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NPI Code Detail

MEDICARE: MS. CHRISTINA SULLIVAN LCSW

MEDICARE: MS. CHRISTINA SULLIVAN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSW7181FL

General Provider Information

NPI Number : 1619002524
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINA SULLIVAN LCSW
Provider Business Mailing Address
First Line : 3012 NE 21ST TER
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33306-1220
Country : US
Telephone Number : 954-253-8399
Fax Number :
Provider Business Practice Location Address
First Line : 6990 GRIFFIN RD
Second Line :
City : DAVIE
State : FL
Zip : 33314-4345
Country : US
Telephone Number : 954-526-4437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 01/05/2026

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