Provider / Organization | NPI | Date Certified |
---|---|---|
MARIAH WYNNE BECK SULLIVAN | 1174115398 | 2022-04-04 |
Mariah Wynne Beck Sullivan is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1174115398. Registration indicates Mariah Wynne Beck Sullivan is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )
Entity Type | Individual |
Provider Name | Mariah Wynne Beck Sullivan |
Practice Office Address | 2149 CENTENNIAL PLZ STE 4 EUGENE, OR US |
Practice Office Telephone | 5417417107 |
Practice Office Fax | 5416879279 |
Mailing Address | 78A CENTENNIAL LOOP EUGENE, OR 974013082 US |
Business Telephone | 5413930777 |
Business Fax | 5416879279 |
Code | Practice | License No State |
---|---|---|
101YM0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor |