Individual
LEANNE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LMHCA
Contact information
Practice address
2832 S MERIDIAN, SUITE 101, PUYALLUP, WA 98373-1447
(253) 474-7188
(253) 446-7137
Mailing address
4227 S MERIDIAN, SUITE #C-576, PUYALLUP, WA 98373-3603
(253) 474-7188
(253) 446-7137
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC 60398056
WA
101YM0800X
Mental Health Counselor
MC 60398056
WA
101YP2500X
Professional Counselor
Primary
MC 60398056
WA
Other
Enumeration date
08/13/2013
Last updated
08/13/2013
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