Individual provider · Type 1 NPI

Henry Earl Sullivan Jr., CADC 1

Addiction (Substance Use Disorder) Counselor · Grants Pass, OR

NPI number 1174986632 Active

Practice location

510 NW 4th St
Grants Pass, OR 97526-2078

Fax (541) 474-5172

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X12-03-48 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

3 other providers at this address

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About NPI 1174986632

Henry Earl Sullivan Jr., CADC 1's National Provider Identifier is 1174986632, issued on Apr 1, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Grants Pass, OR. The record was last updated on Apr 1, 2016.