Individual
VIRGINIA SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Contact information
Practice address
600 S PRESTON ST, LOUISVILLE, KY 40202-1716
(502) 639-3978
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
164999
KY
1041C0700X
Clinical Social Worker
Primary
253088
KY
Other
Enumeration date
04/19/2010
Last updated
10/27/2020
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