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General NPI Number Information
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NPI Number | 1457139610
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Entity Type | Organization
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Legal Business Name | JACKIE SULLIVAN COUNSELING, PLLC
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 47 ORANGE ST STE C
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City | ASHEVILLE
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State | NC
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Zip | 28801-2589
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Country | US
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Telephone | 828-367-9155
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Fax |
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Provider Business Mailing Address
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Address Line | 295 BRICKYARD RD
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City | ASHEVILLE
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State | NC
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Zip | 28806-2816
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Country | US
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Telephone | 828-367-9155
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | MS. JACQUELINE SULLIVAN
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Credential | MSW, LCSW
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Telephone | 678-938-0093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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