| Doctor Name: | MR. DANIEL ALLEN SULLIVAN |
| NPI Number: | 1013264605 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.ED. |
| License Number: | |
| Business Practice Address: | 11 Circle Ave Lynn, MA - 019053050 |
| Business Phone Number: | 7815952413 |
| Business Fax Number: | 7815980210 |
| Mailing Address: | 104 Delmont Ave Apt 19, LOWELL |
| State: | MA |
| Postal Code: | 018525759 |
| Phone Number: | 7744540581 |
| Fax Number: | |
| NPI Enumeration Date: | 08/14/2012 |
| NPI Last Update Date: | 08/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |