Provider Demographics
NPI:1750904652
Name:SULLIVAN, RORY (MA)
Entity type:Individual
Prefix:
First Name:RORY
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 ACCESS RD STE 24
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-5233
Mailing Address - Country:US
Mailing Address - Phone:781-336-5040
Mailing Address - Fax:
Practice Address - Street 1:89 ACCESS RD STE 24
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-5233
Practice Address - Country:US
Practice Address - Phone:781-336-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2025-08-15
Deactivation Date:2025-05-05
Deactivation Code:
Reactivation Date:2025-08-15
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician