Individual
JOHN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
901 PAVILION CT, MCDONOUGH, GA 30253-6665
(678) 814-4375
Mailing address
901 PAVILION CT, MCDONOUGH, GA 30253-6665
(678) 814-4375
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC013465
GA
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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