# AMANDA L SULLIVAN, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497005805
- **Authorized official:** AMANDA L SULLIVAN LMHP, CMSW (PRESIDENT)
- **Authorized official phone:** (402) 432-0679

## Contact information

- **Practice address:** 770 N COTNER BLVD STE 330, LINCOLN, NE 68505-2377
- **Practice address phone:** (402) 904-4067
- **Mailing address:** 770 N COTNER BLVD STE 330, LINCOLN, NE 68505-2377
- **Mailing address phone:** (402) 904-4067

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2012
- **Last updated:** 01/08/2019