Provider Demographics
NPI:1538316427
Name:SULLIVAN, MARGARET LOUISE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:LOUISE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 E TORRENCE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3819
Mailing Address - Country:US
Mailing Address - Phone:614-262-2794
Mailing Address - Fax:
Practice Address - Street 1:3620 N HIGH ST
Practice Address - Street 2:SUITE NUMBER 207
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3611
Practice Address - Country:US
Practice Address - Phone:614-906-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS070008104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker