| Mark Sullivan Llc | |
|
8703 Milford Ave Silver Spring MD 20910-5030 | |
| (202) 264-0070 | |
| Not Available |
| Full Name | Mark Sullivan Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8703 Milford Ave, Silver Spring, Maryland |
| Authorized Official Name and Position | Mark J Sullivan (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2022640070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Sullivan Llc 8703 Milford Ave Silver Spring MD 20910-5030 Ph: (202) 264-0070 | Mark Sullivan Llc 8703 Milford Ave Silver Spring MD 20910-5030 Ph: (202) 264-0070 |
| NPI Number | 1710470711 |
|---|---|
| Provider Enumeration Date | 06/13/2018 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Medicare PECOS PAC ID | 8628328630 |
|---|---|
| Medicare Enrollment ID | O20180912000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710470711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC50079401 (District Of Columbia) | Primary |
| Provider Name | Mark Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346614641 PECOS PAC ID: 9537419544 Enrollment ID: I20180912000350 |
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