Individual
MS. BETH LOUISE SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2611 12TH ST S, WISCONSIN RAPIDS, WI 54494
(715) 421-8840
(715) 421-8858
Mailing address
111 W JACKSON ST, WISCONSIN RAPIDS, WI 54495-2702
(715) 421-8845
(715) 421-2266
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2697125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39724500
—
WI
Enumeration date
11/28/2006
Last updated
10/10/2025
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