Individual
KIMBERLY PAIGE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
PO BOX 748465, ATLANTA, GA 30374-8465
(229) 800-9695
(617) 807-0958
Mailing address
3673 MANHATTAN DR, DECATUR, GA 30034-6109
(423) 503-8633
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW008007
GA
1041C0700X
Clinical Social Worker
Primary
CSW007302
GA
Other
Enumeration date
05/03/2018
Last updated
04/17/2025
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