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Organization

CHILD AND PARENT SUPPORT SERVICES

Active
Other names
Center for Child and Family Health
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KELLY MARIE SULLIVAN PHD, LP (DIR CLINICAL SERVICE)
(919) 419-3474
Entity
Organization

Contact information

Practice address
411 W CHAPEL HILL ST, SUITE 908, DURHAM, NC 27701-3616
(919) 419-3474
(919) 419-9353
Mailing address
411 W CHAPEL HILL ST, SUITE 908, DURHAM, NC 27701-3616
(919) 419-3474
(919) 419-9353

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8300026
NC
Enumeration date
02/19/2007
Last updated
03/27/2013
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