Sullivan, Jessie Elaine

Sullivan, Jessie Elaine is an sole proprietor health care provider with primary practice located at 660 S Woodruff Ave , Idaho Falls ID 83401-5299. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Sullivan, Jessie Elaine can be contacted via phone (208) 523-1558.

Contact Information

Primary practice address
660 S Woodruff Ave Idaho Falls ID 83401-5299
Phone: (208) 523-1558
Fax: (208) 529-4788
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LCPC-119 Idaho
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LMFT-2963 Idaho

Profile Details

NPI number 1063674786
LBN Legal business name Sullivan, Jessie Elaine
Credentials LCPC,LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 25th, 2008
Last updated Jun 16th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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