NPI Registry.org

Edward Mark Sullivan

NPI Registration Record

Provider / OrganizationNPIDate Certified
EDWARD MARK SULLIVAN16594076742007-02-26

Edward Mark Sullivan [M] graduated in 1985 and primarily specializes in Clinical Social Worker.

Edward Mark Sullivan is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1659407674. Registration indicates Edward Mark Sullivan is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Social Worker (Behavioral Health & Social Service Providers, Social Worker) (Social Worker: Clinical, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker Clinical, Behavioral Health & Social Service Providers) (Social Worker, )

PECOS ID4385874049
RegistrationPART-B:Y
DME:Y
HHA:N
PMD:N
Entity TypeIndividual
Provider Name Edward Mark Sullivan MSW, LISW-S
Practice Office Address570 N STATE ST STE 220C
WESTERVILLE, OH US
Practice Office Telephone6146968400
Practice Office Fax6143629909
Mailing Address570 N STATE ST STE 220C
WESTERVILLE, OH 430828086 US
Business Telephone6146968400
Business Fax6143629909
Offices / Locations
AddressCity / StatePhone / Fax
6000 Cooper Rd Westerville, OH 430818984 6146968400 / 6143629909
HPT Codes
CodePractice
License No
State
1041C0700X PRIMARYAccess to Mental Health/Behavioral Health Providers
Behavioral Health & Social Service Providers
Social Worker
Behavioral Health & Social Service Providers
Social Worker
Social Worker: Clinical

Behavioral Health/Substance Abuse/Psychiatry

Social Worker Clinical
Behavioral Health & Social Service Providers
Social Worker
I0004577
OH
OPI Codes
0243763 MEDICAID OH
PO1698877 OTHER OH MEDICARE
0041581 MEDICAID OH
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