Organization
SULLIVAN COUNSELING INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN JOANN SULLIVAN LMFT (OWNER)
(516) 662-1158
Entity
Organization
Contact information
Practice address
1024 N HAMILTON AVE, LINDENHURST, NY 11757-2129
(516) 662-1158
Mailing address
21 GREENE AVE, AMITYVILLE, NY 11701-2943
(516) 743-8571
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
001177
NY
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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