Provider Demographics
NPI:1588822928
Name:SULLIVAN, KAY LOUISE (LMHC LPC)
Entity Type:Individual
Prefix:MRS
First Name:KAY
Middle Name:LOUISE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:LMHC LPC
Other - Prefix:MRS
Other - First Name:KAY
Other - Middle Name:PAGE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC LPC
Mailing Address - Street 1:2241 SARASOTA CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-7811
Mailing Address - Country:US
Mailing Address - Phone:941-365-1762
Mailing Address - Fax:941-359-2209
Practice Address - Street 1:2241 SARASOTA CENTER BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-7811
Practice Address - Country:US
Practice Address - Phone:941-365-1762
Practice Address - Fax:941-359-2209
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-31
Last Update Date:2008-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3651101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health