Jessie Elaine Sullivan in Idaho Falls - Marriage & Family Therapist
Jessie Elaine Sullivan - NPI 1063674786
Jessie Elaine Sullivan is a Marriage & Family Therapist in Idaho Falls, Idaho. Jessie Elaine Sullivan practices all healthcare services and medical treatments related to Marriage & Family Therapist. The NPI Number for Jessie Elaine Sullivan is 1063674786. The last update date is 2011-06-16.
Jessie Elaine Sullivan's current location address is 3785 Colts Glen Ln, Idaho Falls, Idaho. You can contact this provider via phone number 2085242411. The mailing address for Jessie Elaine Sullivan is 3785 Colts Glen Ln, Idaho Falls, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jessie Elaine Sullivan |
|---|---|
| Address | 3785 Colts Glen Ln, Idaho Falls, Idaho |
| Phone Number | 2085242411 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCPC,LMFT |
NPI Number Detail
| NPI Number | 1063674786 |
|---|---|
| Provider Enumeration Date | 2008-06-25 |
| Last Updated Date | 2011-06-16 |
Provider Mailing Address Detail
| Address | 3785 Colts Glen Ln |
|---|---|
| City | Idaho Falls |
| State | Idaho (ID) |
| Post Code | 834048353 |
| Phone Number | 2085242411 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Marriage & Family Therapist |
|---|---|
| Taxonomy | 106H00000X |
| Licence No | LMFT-2963 |
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Definition: A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives |
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What is the unique identifier code issued to Jessie Elaine Sullivan by the Centers for Medicare & Medicaid Services?
The Jessie Elaine Sullivan has been assigned the NPI (National Provider Identifier) 1063674786. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Jessie Elaine Sullivan is physically located?
The Jessie Elaine Sullivan is physically situated at the following address: 3785 Colts Glen Ln, Idaho Falls, ID, 834048353.
What is Jessie Elaine Sullivan's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Jessie Elaine Sullivan is Marriage & Family Therapist, and the taxonomy code that categorizes this field of expertise is 106H00000X.
On what date was the 1063674786 assigned to Jessie Elaine Sullivan?
The Jessie Elaine Sullivan was issued its 1063674786 on 2008-06-25, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Jessie Elaine Sullivan most recently updated?
The details pertaining to the Jessie Elaine Sullivan, including its address, specialty, and other relevant information, were last refreshed on 2011-06-16.
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