Provider Demographics
NPI:1073808093
Name:SULLIVAN, MEAGHAN JILL (MSW)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:JILL
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-3223
Mailing Address - Country:US
Mailing Address - Phone:978-836-1808
Mailing Address - Fax:
Practice Address - Street 1:225 ELM STREET
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-3223
Practice Address - Country:US
Practice Address - Phone:978-836-1808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker