Individual
KEVIN P SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
5000 CEDAR PLAZA PKWY, SUITE 350, SAINT LOUIS, MO 63128-3854
(314) 843-4333
(314) 843-4856
Mailing address
5000 CEDAR PLAZA PKWY, SUITE 350, SAINT LOUIS, MO 63128-3854
(314) 843-4333
(314) 843-4856
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2002032343
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002032343
MO LICENSE
MO
Enumeration date
11/17/2006
Last updated
07/12/2007
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