Individual
MS. CHRISTIANNA LYNN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW LCPC
Contact information
Practice address
351 WILLIAMS LN, CHATHAM, IL 62629-1044
(217) 553-6678
Mailing address
1521 S GLENWOOD AVE, SPRINGFIELD, IL 62704-3608
(217) 553-6678
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180011835
IL
1041C0700X
Clinical Social Worker
Primary
149020276
IL
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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