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Individual

PIPER SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
517 W SHENANDOAH ST, ROSEBURG, OR 97471-2566
(541) 580-0525
(541) 672-4272
Mailing address
517 W SHENANDOAH ST, ROSEBURG, OR 97471-2566
(541) 580-0525
(541) 672-4272

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C3182
OR
101YP2500X
Professional Counselor
Primary
C3182
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500659547
OR
01
C3182
LPC - OREGON
OR
Enumeration date
01/10/2007
Last updated
07/21/2016
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