MS. Jessie Elaine Sullivan, LCPC,LMFT
NPI #1063674786 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1063674786
- Entity Type
- Individual
- Name
- MS. Jessie Elaine Sullivan, LCPC,LMFT
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Credential
- LCPC,LMFT
- Enumeration Date
- Jun 25, 2008
- Last Updated
- Jun 16, 2011
Practice Location
- Address
- 660 S WOODRUFF AVE
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83401-5299
- Phone
- (208) 523-1558
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
| Marriage & Family Therapist |
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