Individual ProviderJennifer SullivanCounselorBehavioral Health & Social Service ProvidersPractice Address1801 American Blvd E Ste 1, Bloomington, MN 55425-1230(612) 331-9413PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Sullivan is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1568987378Provider TypeIndividualFull NameSullivan, JenniferGenderFemaleSole ProprietorNoEnumeration Date8/14/2017Last Updated8/14/2017Contact InformationPractice LocationPractice Address1801 American Blvd E Ste 1, Bloomington, MN 55425-1230Phone(612) 331-9413FaxUnlisted FaxMailing LocationMailing Address1801 American Blvd E Ste 1, Bloomington, MN 55425-1230PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer