Individual
MR. JAMES EDWARD SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA. PSY
Contact information
Practice address
2076 WALLUM LAKE RD, PASCOAG, RI 02859
(401) 568-1770
Mailing address
195 ADMIRAL KALBFUS RD APT 12E, NEWPORT, RI 02840-1372
(718) 909-6197
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/10/2008
Last updated
07/10/2008
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