Agnes Sullivan | Richmond Hill, NY • PECOS Search

Agnes Sullivan

Social Worker

Behavioral Health & Social Service Providers

8546 115th St, Richmond Hill, NY 11418-1732

PECOS Enrollment

Based on the most recent information from CMS, provider Agnes Sullivan does not have current enrollment records in PECOS.

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

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1467188052
Provider Type
Individual
Full Name
Sullivan, Agnes
Title
Mrs.
Credential
LCSW, MSC, BSC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/27/2022
Last Updated
7/27/2022

Contact Information

Practice Location

8546 115th St, Richmond Hill, NY 11418-1732

Unlisted Fax

Mailing Location

8546 115th St, Richmond Hill, NY 11418-1732

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 076573 New York