Individual
BRENNA MARIE O'SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
52 COVE ST, PORTLAND, ME 04101-2514
(207) 956-5977
Mailing address
52 COVE ST, PORTLAND, ME 04101-2514
(207) 956-5977
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL5915
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XL5915
STATE OF MAINE BOARD OF COUNSELING PROFESSIONALS LICENSURE
ME
Enumeration date
02/03/2021
Last updated
02/03/2021
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