Organization
KRIS SULLIVAN LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE SULLIVAN LCSW (OWNER)
(812) 333-3939
Entity
Organization
Contact information
Practice address
3105 S SARE RD APT 300, BLOOMINGTON, IN 47401-4378
(812) 333-3939
Mailing address
3105 S SARE RD APT 300, BLOOMINGTON, IN 47401-4378
(812) 333-3939
(812) 585-3802
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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