Provider Demographics
NPI:1871636548
Name:O'SULLIVAN, MAUREEN BRIDGIT (LPC, LSW)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:BRIDGIT
Last Name:O'SULLIVAN
Suffix:
Gender:F
Credentials:LPC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1407
Mailing Address - Country:US
Mailing Address - Phone:216-261-7887
Mailing Address - Fax:261-291-2611
Practice Address - Street 1:250 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1407
Practice Address - Country:US
Practice Address - Phone:216-261-7887
Practice Address - Fax:261-291-2611
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC-0004742101YM0800X
OHS0006643104100000X
OH2280621041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool