Mark Sullivan, LICSW

NPI 1790813509 · on the registry since 2007 · sole proprietor

Practice

Address: 111 Torrey St
Brockton, MA 02301
Phone: (508) 584-5190
Organisation at this address: Bethel Medical Group Pc
Apex Medical Wellness Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 13

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: MA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Massachusetts