Dianne Bernadette Sullivan, MED LMFT
Individual provider Active NPI Marriage & Family Therapist · Harford, CT
NPI 1497960603 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497960603
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 000497 (CT)
- Practice address
- 714 Prospect Avenue
Harford, CT 06105 - Phone
- (860) 586-8800
- Fax
- (860) 570-0886
- NPI assigned
- May 11, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000497 | CT | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 000497 | CT | Yes |
Addresses
Primary practice location
714 Prospect Avenue
Harford, CT 06105
Mailing address
714 Prospect Avenue
Hartford, CT 06105
Phone (860) 586-8800
Other names
- Dianne Celia Sullivan
Other providers in Harford, CT
All providers in Harford, CT · Marriage & Family Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.