| Doctor Name: | BRENDA SULLIVAN-RICE |
| NPI Number: | 1073712626 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149006017 |
| Business Practice Address: | 1006 S Division St Carterville, IL - 629181539 |
| Business Phone Number: | 6189854841 |
| Business Fax Number: | 6189858101 |
| Mailing Address: | 109 California St, P O Box 577 CARTERVILLE |
| State: | IL |
| Postal Code: | 629180577 |
| Phone Number: | 6189853151 |
| Fax Number: | 6189854635 |
| NPI Enumeration Date: | 07/13/2007 |
| NPI Last Update Date: | 10/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149006017 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |