Provider Demographics
NPI:1427642008
Name:SULLIVAN, LEMAY & ASSOCIATES BEHAVIORAL HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:SULLIVAN, LEMAY & ASSOCIATES BEHAVIORAL HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-559-6922
Mailing Address - Street 1:97 SOUTH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1964
Mailing Address - Country:US
Mailing Address - Phone:860-461-0504
Mailing Address - Fax:
Practice Address - Street 1:97 SOUTH ST STE 105
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-1964
Practice Address - Country:US
Practice Address - Phone:860-461-0504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health