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General NPI Number Information
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NPI Number | 1003702648
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY AND WELLNESS BY SULLIVAN CONSULTING, LLC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1225 US 27 S STE 209
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City | SEBRING
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State | FL
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Zip | 33870-2145
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Country | US
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Telephone | 786-597-8543
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Fax | 954-301-8142
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Provider Business Mailing Address
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Address Line | 1225 US 27 S
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City | SEBRING
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State | FL
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Zip | 33870-2144
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Country | US
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Telephone | 786-597-8543
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Fax | 954-301-8142
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Authorized Official
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Title or Position | OWNER
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Name | DIANA P SULLIVAN
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Credential |
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Telephone | 954-253-2584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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