Individual
DR. BRADY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
3115 S GRAND BLVD STE 300, SAINT LOUIS, MO 63118-1046
(314) 339-7356
Mailing address
4325 LOUGHBOROUGH AVE, SAINT LOUIS, MO 63116-2103
(630) 885-8663
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2018014894
MO
101YM0800X
Mental Health Counselor
2018014894
MO
Other
Enumeration date
05/08/2018
Last updated
05/04/2022
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