Provider Demographics
NPI:1427719350
Name:CRAGAN-SULLIVAN, LORRAINE JULIE (LMSW)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:JULIE
Last Name:CRAGAN-SULLIVAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 FARRS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-1905
Mailing Address - Country:US
Mailing Address - Phone:864-475-9938
Mailing Address - Fax:864-568-3938
Practice Address - Street 1:205 FARRS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29617-1905
Practice Address - Country:US
Practice Address - Phone:864-475-9938
Practice Address - Fax:864-568-3938
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9885104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker