Individual
NICOLE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
160 ATLANTIC CITY BLVD, BAYVILLE, NJ 08721-1229
(732) 349-5550
Mailing address
160 ATLANTIC CITY BLVD, BAYVILLE, NJ 08721-1229
(732) 349-5550
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37AC00219500
NJ
101YP2500X
Professional Counselor
37PC00594000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37PC00594000
NJ BOARD OF MARRIAGE AND FAMILY THERAPY EXAMINERS
NJ
Enumeration date
03/14/2015
Last updated
07/21/2022
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