Individual
KATHERINE BERES SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, CSACS
Contact information
Practice address
8150 LEESBURG PIKE, VIENNA, VA 22182-7715
(703) 568-3585
Mailing address
3019 N ST NW, WASHINGTON, DC 20007-3405
(703) 568-3585
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0709025087
VA
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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