| Brady Sullivan Consulting, Llc | |
|
3115 S Grand Blvd Ste 300 Saint Louis MO 63118-1046 | |
| (314) 339-7356 | |
| Not Available |
| Full Name | Brady Sullivan Consulting, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3115 S Grand Blvd Ste 300, Saint Louis, Missouri |
| Authorized Official Name and Position | Brady Sullivan (FOUNDER) |
| Authorized Official Contact | 3143397356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brady Sullivan Consulting, Llc 4325 Loughborough Ave Saint Louis MO 63116-2103 Ph: (630) 885-8663 | Brady Sullivan Consulting, Llc 3115 S Grand Blvd Ste 300 Saint Louis MO 63118-1046 Ph: (314) 339-7356 |
| NPI Number | 1003551995 |
|---|---|
| Provider Enumeration Date | 05/04/2022 |
| Last Update Date | 05/04/2022 |
| Certification Date | 05/04/2022 |
| Medicare PECOS PAC ID | 7315383221 |
|---|---|
| Medicare Enrollment ID | O20240314001052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003551995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Brady Sullivan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497244115 PECOS PAC ID: 9133565047 Enrollment ID: I20240314001148 |
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