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Individual
SEAN ALYSTON SULLIVAN
Active
Individual
SEAN ALYSTON SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASE MANAGER
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1194366070
AK
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
—
AK
Other
Enumeration date
10/02/2019
Last updated
03/31/2022
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