Individual
KELLY COLLEEN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, PLMHP
Contact information
Practice address
6180 LEHMAN DR, COLORADO SPRINGS, CO 80918-3444
(719) 452-4803
Mailing address
25 SOMMERLYN RD APT 1003, COLORADO SPRINGS, CO 80906-3406
(605) 890-1812
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC.0019198
CO
101YP2500X
Professional Counselor
12489
NE
Other
Enumeration date
02/03/2021
Last updated
04/06/2023
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