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General NPI Number Information
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NPI Number | 1669197943
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Entity Type | Organization
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Legal Business Name | ADAM SULLIVAN LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 9 LAKE BELLEVUE DR STE 217
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City | BELLEVUE
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State | WA
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Zip | 98005-2454
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Country | US
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Telephone | 206-486-5642
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Fax | 206-338-0639
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Provider Business Mailing Address
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Address Line | 240 S SUNNYSIDE AVE UNIT 187
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City | SEQUIM
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State | WA
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Zip | 98382-4007
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Country | US
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Telephone | 206-486-5642
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Fax | 206-338-0639
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Authorized Official
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Title or Position | OWNER
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Name | ADAM SULLIVAN
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Credential | LMHC
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Telephone | 206-486-5642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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