Organization
CENTER FOR CHILD AND FAMILY HEALTH
Active
Other names
Center for Child and Family Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY MARIE SULLIVAN PHD, LP (DIRECTOR OF MENTAL HEALTH SERVICES)
(919) 419-3474
Entity
Organization
Contact information
Practice address
1121 W CHAPEL HILL ST, SUITE 100, DURHAM, NC 27701-3027
(919) 419-3474
(919) 419-9353
Mailing address
1121 W CHAPEL HILL ST, SUITE 100, DURHAM, NC 27701-3027
(919) 419-3474
(919) 419-9353
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005053
—
NC
05
—
890144U
—
NC
Enumeration date
02/14/2007
Last updated
07/18/2015
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