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Daniel J. Sullivan

Counselor

Behavioral Health & Social Service Providers

2811 Linkhorne Dr, Suite B, Lynchburg, VA 24503-3321

PECOS Enrollment

This provider is enrolled in PECOS as DANIEL SULLIVAN.

Based on the most recent information from CMS, provider Daniel J. Sullivan is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1861459653
Provider Type
Individual
Full Name
Sullivan, Daniel J.
Credential
LPC

Gender
Male
Enumeration Date
4/27/2006
Last Updated
7/8/2007

Contact Information

Practice Location

2811 Linkhorne Dr, Suite B, Lynchburg, VA 24503-3321

(434) 384-1594

Unlisted Fax

Mailing Location

2811 Linkhorne Dr, Suite B, Lynchburg, VA 24503-3321

(434) 384-1594

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 0701003299 Virginia

Provider Identifiers

ID	Description	Issuer
ID 186387	Description Other	Issuer ANTHEM Virginia

Daniel J. Sullivan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Thompson, Stacey

Sova, Patricia

Stone, Melisa M.

Brooks, Jeanne D

Demato, Doris

Hutchison, James Ralph

Cassada, Nina D

Blevins, Elizabeth S

Declet Rodriguez, Guadalupe

Blackwell, Mary Clayton