Erin E Donovan
Individual provider Active NPI Social Worker · Sullivan, IL
NPI 1003511247 · NPPES record last updated Apr 4, 2023
Key facts
- NPI
- 1003511247
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 12 W Harrison St
Sullivan, IL 61951-1907 - Phone
- (217) 728-4358
- NPI assigned
- Apr 4, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moultrie County Mental Health Center | Current |
Accepting new patients |
Locations
12 W Harrison St
Sullivan, IL 61951
Phone (217) 728-4358
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
12 W Harrison St
Sullivan, IL 61951-1907
Mailing address
12 W Harrison St
Sullivan, IL 61951-1907
Other providers in Sullivan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.