Individual
DAVID LYNN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC PLMHP
Contact information
Practice address
1620 S 70TH ST, LINCOLN, NE 68506-1563
(402) 202-9342
Mailing address
2742 S 39TH ST, LINCOLN, NE 68506-3234
(402) 202-9342
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1252
NE
101YM0800X
Mental Health Counselor
11360
NE
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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