Organization
AMANDA L SULLIVAN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA L SULLIVAN LMHP, CMSW (PRESIDENT)
(402) 432-0679
Entity
Organization
Contact information
Practice address
770 N COTNER BLVD STE 330, LINCOLN, NE 68505-2377
(402) 904-4067
Mailing address
770 N COTNER BLVD STE 330, LINCOLN, NE 68505-2377
(402) 904-4067
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/12/2012
Last updated
01/08/2019
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