Individual
DR. BERNARD JOHN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10540 MARTY ST STE 155, OVERLAND PARK, KS 66212-2654
(913) 451-2843
(913) 383-1088
Mailing address
10540 MARTY ST STE 155, OVERLAND PARK, KS 66212-2654
(913) 451-2843
(913) 383-1088
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP-0436
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07571-01-0
BLUE CROSS PROVIDER #
MO
01
—
606084
BLUE CROSS PROVIDER
KS
Enumeration date
03/22/2007
Last updated
07/08/2007
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