MR. BRADY SULLIVAN (NPI# 1497244115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497244115 |
Entity Type | Individual |
Full Name | MR. BRADY SULLIVAN |
Credential | PLPC |
Practice Address |
5859 S Kingshighway Blvd Fl 1 Saint Louis MO 63109-3571 |
Mailing Address |
934 Quail Terrace Ct Apt E Ballwin MO 63021-8321 |
Practice Telephone | 3146696242 |
Mailing Telephone | 6308858663 |
Enumeration Date | 2018-05-08 |
Last Update Date | 2018-05-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101Y00000X | Counselor | 2018014894 | MO | Behavioral Health & Social Service Providers |
Street Address |
5859 S KINGSHIGHWAY BLVD FL 1 |
City | SAINT LOUIS |
State | MO |
Zip Code | 63109-3571 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033626981 | Christina Warden | Counselor | 5859 S Kingshighway Blvd Fl 1, Saint Louis, MO 63109-3571 | 2018-01-01 |
1144792003 | Lauren N Thayer | Counselor | 5859 S Kingshighway Blvd Fl 1, Saint Louis, MO 63109-3571 | 2018-12-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013431907 | James Edward Trout | Community Health Worker | 3956 Wenzlick Ave, St Louis, MO 63109 | 2017-08-01 |
1750815023 | Andrea Hyde | Nurse Practitioner | 5302 Chippewa Street, Suite 301, St Louis, MO 63109 | 2017-04-13 |
1215362124 | Alex Sharifian Dds Francis Park Dentistry PC | Dentist | 6650 Chippewa Street, Saint Louis, MO 63109 | 2013-09-10 |
1881993962 | Rachel Elizabeth Hale Hasper | Counselor | 6555 Chippewa, St Louis, MO 63109 | 2011-03-15 |
1730369885 | Janis Marie Lampa | Physical Therapist | 5203 Chippewa, Suite 301, St. Louis, MO 63109 | 2007-11-06 |
1285753772 | James Matthew Jordan | Occupational Therapist | 32 Hampton Village Plaza, St Louis, MO 63109 | 2007-03-28 |
1730224478 | Mercy Health Services, LLC | Optometrist | 34 Hampton Village Plaza, St. Louis, MO 63109 | 2007-02-20 |
1801959903 | John Thomas Doyle | Dentist | 5400 Walsh St, St Louis, MO 63109 | 2006-12-19 |
1649339771 | Residencial Services Corporation | Assisted Living Facility | 5890 Eichelberger, St Louis, MO 63109 | 2006-12-06 |
1316039852 | Gary Raymond Rieser | Dentist | 3915 Watson Road, Suite 205, Saint Louis, MO 63109 | 2006-09-29 |
Find all providers in zip 63109 |
Taxonomy Code | 101Y00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548861644 | Barbara Schuver | Counselor | 1709 Rosearbor Dr, Saint Louis, MO 63146-4724 | 2020-11-04 |
1255946356 | Jessika Triplett | Counselor | 9909 Manchester Rd # 134, Saint Louis, MO 63122-1915 | 2020-09-15 |
1629689344 | Jennifer Walsh | Counselor | 5704 Rosa Ave, Saint Louis, MO 63109-3256 | 2020-08-14 |
1952910408 | Tiffany Wingo | Counselor | 4143 California Ave, Saint Louis, MO 63118-4507 | 2020-07-29 |
1952922528 | Kevin Mcculloch | Counselor | 4100 Forest Park Ave Apt 423, Saint Louis, MO 63108-2897 | 2020-05-05 |
1659912954 | Merrick Hughes | Counselor | 2800 Stoddard St Apt 201, Saint Louis, MO 63106-2211 | 2019-10-08 |
1821649757 | John Lucas | Counselor | 200 S Bemiston Ave Ste 101, Saint Louis, MO 63105-1915 | 2019-09-23 |
1841840618 | Christa Elizabeth Walker | Counselor | 12360 Manchester Rd Ste 100, Saint Louis, MO 63131-4312 | 2019-09-13 |
1477013944 | Wonakee Terrisita Robinson Jr. | Counselor | 5950 Drury Ln, Saint Louis, MO 63147-1112 | 2019-03-21 |
1952884397 | Marni A Deutsch | Counselor | 7751 Carondelet Ave Ste 600b, Saint Louis, MO 63105-4043 | 2018-09-12 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63109 |
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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.