DR. BERNARD HARRELL SULLIVAN JR.


Address: 203 N Hoffman St, Dallas, NC 28034-1525
Phone: 7048134033

DR. BERNARD HARRELL SULLIVAN JR. (NPI# 1326282633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326282633
Entity Type Individual
Full Name DR. BERNARD HARRELL SULLIVAN JR.
Credential PHD
Practice Address 203 N Hoffman St
Dallas
NC 28034-1525
Practice Telephone 7048134033
Mailing Telephone 7048134033
Enumeration Date 2009-04-30
Last Update Date 2019-01-14
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
102806 NC Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC BCBS NC 1817W 01
NC 6001164 05

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Office Location

Street Address 203 N HOFFMAN ST
City DALLAS
State NC
Zip Code 28034-1525

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1730327305 Ingles Markets Inc Pharmacy 715 W Trade St, Dallas, NC 28034 2009-02-04
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1518469204 Daria Fowler Counselor 107 N Summey St, Dallas, NC 28034 2018-03-08
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

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1801430483 Yaffa Podbilewicz-schuller Psychologist 6618 Elvedon Dr, Dallas, TX 75248-1324 2019-11-06
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1275001208 Bryan Elliott Jester Psychologist 4100 Spring Valley Rd Ste 511, Dallas, TX 75244-3678 2018-11-07
1003398074 Aaron Hands Psychologist 5646 Milton St Ste 740, Dallas, TX 75206 2018-09-05
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Competitor

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City DALLAS
Zip Code 28034

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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