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Individual

DAVID SULLIVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LAC

Contact information

Practice address
2955 VALMONT RD STE 110, BOULDER, CO 80301-1360
(720) 492-7254
Mailing address
2955 VALMONT RD STE 110, BOULDER, CO 80301-1360
(720) 492-7254

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
770
CO
1041C0700X
Clinical Social Worker
Primary
9924117
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
50770080
CO
Enumeration date
09/09/2008
Last updated
04/09/2025
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