Individual
DR. MICHAEL A SULLIVAN-TIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCAC
Contact information
Practice address
1030 JEFFERSON AVE, MEMPHIS, TN 38104-2127
(317) 748-8710
Mailing address
3400 LEBANON RD, MURFREESBORO, TN 37129-1392
(615) 225-4729
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000061A
IN
1041C0700X
Clinical Social Worker
Primary
34005914A
IN
Other
Enumeration date
08/30/2010
Last updated
02/14/2019
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