Provider Demographics
NPI:1942919774
Name:SULLIVAN, KATHRYN (PHD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 E 42ND ST FL 46
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10165-0043
Mailing Address - Country:US
Mailing Address - Phone:914-365-7755
Mailing Address - Fax:
Practice Address - Street 1:60 E 42ND ST FL 46
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10165-0043
Practice Address - Country:US
Practice Address - Phone:914-365-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist