MICHAEL GRUER SULLIVAN (NPI# 1063791747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063791747 |
| Entity Type | Individual |
| Full Name | MICHAEL GRUER SULLIVAN |
| Credential | LMHC, MCAP |
| Practice Address |
2024 N. Crystal Lake Dr. Suite 200 Room 205 Lakeland FL 33801-6015 |
| Mailing Address |
503 Granby St Lakeland FL 33801-6015 |
| Practice Telephone | 8634102095 |
| Mailing Telephone | 8638389437 |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2020-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | MH15284 | FL | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
MH15284 | FL | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH15284 | FL | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
MH15284 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366918617 | Michael David Sullivan | Social Worker | 403 1/2 Hector St, Ithaca, NY 14850-2025 | 2018-10-15 |
| 1376923292 | Michael Sullivan | Student in an Organized Health Care Education/Training Program | Walter Reed 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2015-06-05 |
| 1881074896 | Michael Gregory Sullivan | Intermediate Care Facility, Mentally Retarded | 30 Hobomack Rd, Quincy, MA 02169-2508 | 2015-06-04 |
| 1104215136 | Michael Sullivan | Perfusionist | 137 Founders Way Ct, Cape Girardeau, MO 63701-9442 | 2015-01-14 |
| 1689927915 | Michael Robert Sullivan | Pharmacist | 41 Buena Vista St, Stamford, CT 06907-2402 | 2012-10-24 |
| 1154672038 | Michael James Sullivan | Dentist | 1882 Hard Rd, Columbus, OH 43235-1996 | 2012-10-02 |
| 1457647083 | Michael Patrick Sullivan | Dentist | 1008 G Sreet, Geneva, NE 68361 | 2011-06-22 |
| 1841528585 | Michael Andrew Sullivan | Counselor | 974 73rd St Ste 9, Windsor Heights, IA 50324-1026 | 2009-11-18 |
| 1508191388 | Michael Joseph Sullivan | Audiologist | 6644 Penn Ave S, Richfield, MN 55423-2026 | 2009-10-12 |
| 1588899066 | Michael Sullivan II | Physical Therapy Assistant | 617 Se 5th St, Delray Beach, FL 33483-5222 | 2009-05-27 |
| Street Address |
2024 N. CRYSTAL LAKE DR. SUITE 200 ROOM 205 |
| City | LAKELAND |
| State | FL |
| Zip Code | 33801-6015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473802 | Camryn Nichole White | Assistant Behavior Analyst | 301 South Florida Ave, Lakeland, FL 33801 | 2020-09-30 |
| 1932719242 | Jimia Watkins | Home Health Aide | 2410 Lakeview St, Lakeland, FL 33801 | 2020-08-03 |
| 1396366886 | Erin Zimmer | Health Educator | 491 Lake Parker Ave, Lakeland, FL 33801 | 2020-05-06 |
| 1013473206 | Madelyn Claire Burley | Occupational Therapist | 1215 East Orange Street, Lakeland, FL 33801 | 2019-02-13 |
| 1992260319 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 1617 Us Highway 98 S, Lakeland, FL 33801 | 2019-02-11 |
| 1669908836 | Integrative Physical Medicine of Lakeland LLC | Specialist | 1205 East Magnolia St, Suite 105, Lakeland, FL 33801 | 2017-05-10 |
| 1689111502 | Daryl Dowding | Counselor | 390 Alcaia Rd., Lakeland, FL 33801 | 2017-01-30 |
| 1023481926 | Joseph D'alessandro | Specialist/Technologist | 111 Lake Hollingsworth Dr Box 4334, Lakeland, FL 33801 | 2015-11-02 |
| 1588030894 | Donna Lee Buckner | Specialist/Technologist | 111 Mosswood Road, Lakeland, FL 33801 | 2015-08-20 |
| 1144635780 | Donna Paige Mccraney | Nurse Practitioner | 111 Lake Hollingsworth Drive, Florida Southern College Student Health Center, Lakeland, FL 33801 | 2014-06-23 |
| Find all providers in zip 33801 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626734 | Rowena Allison Barnett | Counselor | 4730 Lakeland Highlands Rd, Lakeland, FL 33813-3125 | 2020-10-15 |
| 1013525039 | Marah Mcaleer | Counselor | 5601 Bloomfield Blvd, Lakeland, FL 33810-8234 | 2020-07-15 |
| 1801417993 | Annie G Leboeuf | Counselor | 7355 Us Highway 98 N, Lakeland, FL 33809-2102 | 2020-04-30 |
| 1477172971 | Florida Counseling Solutions LLC | Counselor | 122 E Main St # 274, Lakeland, FL 33801-4655 | 2020-04-14 |
| 1114553757 | Megan Nance | Counselor | 50 Lake Morton Dr, Lakeland, FL 33801-5343 | 2020-03-16 |
| 1114557360 | Pinder Counseling LLC | Counselor | 4740 Cleveland Heights Blvd Ste 1, Lakeland, FL 33813-2187 | 2020-01-16 |
| 1174162093 | Deborah Beall Boynton | Counselor | 219 Hillcrest St, Lakeland, FL 33815 | 2019-12-23 |
| 1295377745 | Mary Ann Veronica Santiago | Counselor | 4745 Old Road 37, Lakeland, FL 33813-2031 | 2019-10-16 |
| 1407498298 | Altovise L Davis | Counselor | 627 Carolyn Dr, Lakeland, FL 33803-4856 | 2019-10-13 |
| 1255988895 | Glenna Mary Denis | Counselor | 3421 Sleepy Hill Oaks St, Lakeland, FL 33810-3561 | 2019-08-19 |
| Find all providers in LAKELAND | ||||
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| 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.