Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Charles Sullivan, MSW, LICSW

Individual provider Clinical Social Worker · NPI 1114093259

Mr. Charles Sullivan, MSW, LICSW is a Clinical Social Worker in Medford, Massachusetts. Practices as a sole proprietor. Licensed in Vermont.

Licensed in
VT
In the registry since
2006
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

10 High St Ste 10
Medford, MA 02155-3848
Phone: (781) 395-1560
Fax: (781) 391-5564
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 089.0060196 (VT)

Record details

NPI number1114093259
Entity typeIndividual (Type 1)
GenderMale
Credentials MSW , LICSW
Sole proprietorYes
NPI enumeratedNovember 28, 2006
Last updated in NPPESJanuary 4, 2010

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