Individual
MRS. KERRY SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW LCADC ICGC-1
Contact information
Practice address
536 MAPLE AVE, LINWOOD, NJ 08221-1213
(609) 517-0423
Mailing address
38 E REVERE AVE, NORTHFIELD, NJ 08225-2436
(609) 513-2875
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37L00351100
NJ
104100000X
Social Worker
Primary
44SL06785900
NJ
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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