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NPI Code Detail

MEDICARE: MRS. RACHEL O'SULLIVAN LCSW

MEDICARE: MRS. RACHEL O'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 Worker12716-123WI

General Provider Information

NPI Number : 1659030393
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RACHEL O'SULLIVAN LCSW
Provider Business Mailing Address
First Line : 514 RIVERVIEW AVE
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-3631
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 514 RIVERVIEW AVE
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-3631
Country : US
Telephone Number : 262-548-7666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2021
Last Update Date : 12/09/2025

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