| Carol Sullivan, | |
|
1905 Mission 66, Vicksburg, MS 39180-3711 | |
| (601) 738-5820 | |
| Not Available |
| Full Name | Carol Sullivan |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 1905 Mission 66, Vicksburg, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396429932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Carol Sullivan, 1905 Mission 66, Vicksburg, MS 39180-3711 Ph: (601) 738-5820 | Carol Sullivan, 1905 Mission 66, Vicksburg, MS 39180-3711 Ph: (601) 738-5820 |
Kaila Virgil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3334 Wisconsin Ave., Vicksburg, MS 39180 Phone: 601-638-0031 | |
Tiffany Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Felicia Wilson, PCMHT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Heather Potts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 | |
Rosalyn Glascoe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 | |
Ann Nelson, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Mr. Walter Lee Frazier, MCP, LPC, NCC Counselor Medicare: Medicare Enrolled Practice Location: 1414 Cherry St, Vicksburg, MS 39180 Phone: 601-636-5703 Fax: 601-636-5739 |