Provider Demographics
NPI:1942851969
Name:SULLIVAN, CARRIE E (LMHC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:E
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 BROADWAY STE 101
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-4256
Mailing Address - Country:US
Mailing Address - Phone:888-454-3827
Mailing Address - Fax:
Practice Address - Street 1:268 BROADWAY STE 101
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-4256
Practice Address - Country:US
Practice Address - Phone:888-454-3827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY014813101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health