Provider Demographics
NPI:1386459071
Name:SULLIVAN, CATHERINE H (LCSW, LCAC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:H
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:LCSW, LCAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2457 E WASHINGTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201-4182
Mailing Address - Country:US
Mailing Address - Phone:781-354-0175
Mailing Address - Fax:
Practice Address - Street 1:2457 E WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-4182
Practice Address - Country:US
Practice Address - Phone:781-354-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87001753A101YA0400X
IN34010923A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)