MRS. SUSAN ENNS TULLY (NPI# 1568524999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568524999 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN ENNS TULLY |
| Credential | MA,LMHC |
| Practice Address |
3040 N Wickham Rd Suite 10 Melbourne FL 32935-2369 |
| Practice Telephone | 3217517000 |
| Practice Fax Number | 3217517055 |
| Mailing Telephone | 3217517000 |
| Mailing Fax Number | 3217517055 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH5333 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881930576 | Susan M Tully | Physical Therapist | 7 Carnegie Plz, Cherry Hill, NJ 08003-1000 | 2012-12-27 |
| Street Address |
3040 N WICKHAM RD SUITE 10 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-2369 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356333124 | Thomas Glenn Dimarco | Occupational Therapist | 3040 N Wickham Rd, Suite 7, Melbourne, FL 32935-2369 | 2005-08-18 |
| 1316487705 | Danielle Ryba | Speech-Language Pathologist | 3040 N Wickham Rd, Suite 4, Melbourne, FL 32935-2369 | 2017-03-03 |
| 1790135945 | Victoria Scott | Speech-Language Pathologist | 3040 N Wickham Rd, Suite 4, Melbourne, FL 32935-2369 | 2016-06-20 |
| 1689020893 | Dana E Mcclure | Speech-Language Pathologist | 3040 N Wickham Rd, Suite 4, Melbourne, FL 32935-2369 | 2016-05-05 |
| 1336538909 | Jennifer Dolores Jenkins | Speech-Language Pathologist | 3040 N Wickham Rd, Melbourne, FL 32935-2369 | 2015-01-20 |
| 1992130413 | Hsiao Ting Wang | Acupuncturist | 3040 N Wickham Rd, Unit 5, Melbourne, FL 32935-2369 | 2013-09-04 |
| 1073884979 | Jennifer Thompson | Counselor | 3040 N Wickham Rd, Suite 10, Melbourne, FL 32935-2369 | 2012-01-24 |
| 1629209846 | Audrey I Matty | Speech-Language Pathologist | 3040 N Wickham Rd, Suite 7, Melbourne, FL 32935-2369 | 2009-08-05 |
| 1649447038 | Brooke A Wilson | Speech-Language Pathologist | 3040 N Wickham Rd, Suite 4, Melbourne, FL 32935-2369 | 2008-05-14 |
| 1821283300 | Alpha Homecare & Therapy Agency LLC | Home Health | 3040 N Wickham Rd, Suite 7, Melbourne, FL 32935-2369 | 2007-09-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415944 | Danielle Neal | Counselor | 4173 Palladian Way, Melbourne, FL 32904-1210 | 2020-10-21 |
| 1063022317 | 21 Vets Incorporated | Counselor | 4908 Fauna Dr, Melbourne, FL 32934-7847 | 2020-08-03 |
| 1528689122 | Ichoose Change, LLC | Counselor | 1600 Malabar Rd, J-119, Melbourne, FL 32935-1408 | 2020-05-05 |
| 1588283683 | Benah Counseling LLC | Counselor | 3270 Suntree Blvd Ste 155-157, Melbourne, FL 32940-7530 | 2020-04-09 |
| 1033755376 | Tiffany Brown | Counselor | 8080 Kingswood Way, Melbourne, FL 32940-2191 | 2019-11-21 |
| 1245893403 | Adrianne Vyasulu Leonhardt | Counselor | 3230 Arden Cir, Melbourne, FL 32934-8772 | 2019-04-15 |
| 1801356480 | Neeley Renee Hughey | Counselor | 3270 Suntree Blvd Ste 121, Melbourne, FL 32940-7540 | 2019-03-21 |
| 1487135596 | Dyeanna Fuller | Counselor | 1600 W Eau Gallie Blvd Ste 201f, Melbourne, FL 32935-4149 | 2018-08-27 |
| 1811489925 | Wendy Leonard Hixon | Counselor | 1900 S Harbor City Blvd Ste 211, Melbourne, FL 32901-4760 | 2018-06-04 |
| 1639682297 | Senior Counseling Group, LLC | Counselor | 3270 Suntree Blvd Ste 2217, Melbourne, FL 32940-7558 | 2017-11-06 |
| Find all providers in MELBOURNE | ||||
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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.