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Organization
MASTERPIECE COUNSELING LLC
Active
Organization
MASTERPIECE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRUER SULLIVAN LMHC, MCAP (OWNER/OPERATOR)
(863) 410-2095
Entity
Organization
Contact information
Practice address
2420 N CRYSTAL LAKE DR STE 200, LAKELAND, FL 33801-6205
(863) 410-2095
Mailing address
503 GRANBY ST, LAKELAND, FL 33801-6015
(863) 838-9437
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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