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Individual

MR. JOHN W SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
3801 LAKE BOONE TRL, RALEIGH, NC 27607-2934
(919) 784-9182
(919) 784-9184
Mailing address
6609 MOUNTAIN BROOK DR, RALEIGH, NC 27615-7307
(919) 844-1649
(919) 844-1649

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5497
NC

Other

Enumeration date
01/09/2007
Last updated
07/08/2007
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