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Individual
ERIC SULLIVAN
Active
Individual
ERIC SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6510
SC
106H00000X
Marriage & Family Therapist
93601
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01261511
—
CA
Enumeration date
10/23/2012
Last updated
01/31/2018
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