| Gabrielle Sullivan Llc | |
|
2900 S 70th St Ste 160 Lincoln NE 68506-3733 | |
| (402) 995-9277 | |
| (402) 477-8284 |
| Full Name | Gabrielle Sullivan Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2900 S 70th St Ste 160, Lincoln, Nebraska |
| Authorized Official Name and Position | Gabrielle Elizabeth Sullivan (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4029959277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gabrielle Sullivan Llc 2900 S 70th St Ste 160 Lincoln NE 68506-3733 Ph: (402) 995-9277 | Gabrielle Sullivan Llc 2900 S 70th St Ste 160 Lincoln NE 68506-3733 Ph: (402) 995-9277 |
| NPI Number | 1215548748 |
|---|---|
| Provider Enumeration Date | 08/10/2020 |
| Last Update Date | 08/17/2020 |
| Certification Date | 08/17/2020 |
| Medicare PECOS PAC ID | 7911324439 |
|---|---|
| Medicare Enrollment ID | O20200828000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215548748 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gabrielle E Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932550225 PECOS PAC ID: 6103113956 Enrollment ID: I20160922001923 |
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