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Individual

BERONICA LYNN SULLIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4615 GOVERNMENT ST, BATON ROUGE, LA 70806-5922
(225) 922-0478
Mailing address
PO BOX 66558, BATON ROUGE, LA 70896-6558
(225) 246-4700
(855) 473-0115

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
5867
LA
1041C0700X
Clinical Social Worker
Primary
5867
LA

Other

Enumeration date
09/22/2011
Last updated
08/18/2020
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