Roberta J Sullivan | Liberty, MO • PECOS Search

Roberta J Sullivan

Counselor

Behavioral Health & Social Service Providers

9 Victory Dr Ste 3, Liberty, MO 64068-3807

(816) 268-8501 (816) 809-5873

PECOS Enrollment

Based on the most recent information from CMS, provider Roberta J Sullivan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1437661329
Provider Type
Individual
Full Name
Sullivan, Roberta J
Title
Mrs.
Credential
JD, MA

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/31/2017
Last Updated
10/31/2017

Contact Information

Practice Location

9 Victory Dr Ste 3, Liberty, MO 64068-3807

Unlisted Fax

Mailing Location

9022 N Hunter Ave, Kansas City, MO 64157-8515

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 2015034336 Missouri