| Suming Sullivan, Licsw, Llc | |
|
661 Massachusetts Ave Ste 21 Arlington MA 02476-5001 | |
| (617) 512-8102 | |
| Not Available |
| Full Name | Suming Sullivan, Licsw, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 661 Massachusetts Ave Ste 21, Arlington, Massachusetts |
| Authorized Official Name and Position | Suming Chin Sullivan (LICSW, OWNER) |
| Authorized Official Contact | 6175128102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suming Sullivan, Licsw, Llc 661 Massachusetts Ave Ste 21 Arlington MA 02476-5001 Ph: (617) 512-8102 | Suming Sullivan, Licsw, Llc 661 Massachusetts Ave Ste 21 Arlington MA 02476-5001 Ph: (617) 512-8102 |
| NPI Number | 1427632868 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 05/11/2021 |
| Certification Date | 05/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427632868 | NPI | - | NPPES |
| 1326460320 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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