MIRIAM LIZETTE SULLIVAN (NPI# 1740568385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740568385 |
| Entity Type | Individual |
| Full Name | MIRIAM LIZETTE SULLIVAN |
| Credential | MA, LCPC |
| Practice Address |
10725 S Western Ave 2nd Floor Chicago IL 60643-3135 |
| Mailing Address |
6848 W 114th Pl Worth IL 60482-2015 |
| Practice Telephone | 7086912497 |
| Mailing Telephone | 7086912497 |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2017-02-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180.007775 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851404768 | Miriam Jill Sullivan | Radiology | 800 E Carpenter St, Department of Radiology, Springfield, IL 62702-5324 | 2006-08-16 |
| Street Address |
10725 S WESTERN AVE 2ND FLOOR |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306866132 | Patricia Joan Harthun | Counselor | 10725 S Western Ave, 2nd Floor, Chicago, IL 60643-3135 | 2006-07-21 |
| 1205474475 | New Directions Therapy, Ltd. | Community/Behavioral Health | 10725 S Western Ave, Chicago, IL 60643-3217 | 2019-12-18 |
| 1841836962 | Love Yogaself Therapy LLC | Community/Behavioral Health | 10725 S Western Ave, Chicago, IL 60643-3135 | 2019-11-24 |
| 1982249850 | Chrysanthemum Counseling, Ltd | Social Worker | 10725 S Western Ave, Chicago, IL 60643-3135 | 2019-11-14 |
| 1972002483 | James Thomas Peltzer II | Counselor | 10725 S Western Ave, Chicago, IL 60643-3135 | 2018-02-09 |
| 1275075632 | Pete Hardy | Counselor | 10725 S Western Ave, Chicago, IL 60643-3135 | 2016-11-15 |
| 1841741048 | Shavaughn Carey | Social Worker | 10725 S Western Ave, Chicago, IL 60643-3135 | 2016-10-23 |
| 1316498561 | Basarida Wellness, LLC | Social Worker | 10725 S Western Ave, 2nd Floor, Chicago, IL 60643-3135 | 2016-10-21 |
| 1295198141 | Dennis Klacko | Counselor | 10725 S Western Ave, Chicago, IL 60643-3135 | 2016-03-29 |
| 1710360458 | Patricia Harthun Lcpc Ltd | Counselor | 10725 S Western Ave, 2nd Floor, Chicago, IL 60643-3135 | 2015-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1073114591 | Alternative Schools Network | Counselor | 1807 W Sunnyside Ave, Chicago, IL 60640-5898 | 2020-11-02 |
| 1992306518 | Gravity and Grace Psychotherapy, Pllc | Counselor | 1305 S Michigan Ave Apt 602, Chicago, IL 60605-3398 | 2020-11-02 |
| 1811597263 | April Wilburne | Counselor | 804 E 54th St Apt 3, Chicago, IL 60615-4972 | 2020-10-27 |
| 1043810393 | Pamela Kranyak | Counselor | 30 N Michigan Ave Ste 925, Chicago, IL 60602-3463 | 2020-10-27 |
| 1003413378 | Erika Aguirre | Counselor | 5040 S Keating Ave., Chicago, IL 60632-4919 | 2020-10-08 |
| 1497361661 | Michael V Biederman | Counselor | 4254 N Mozart St Apt 2s, Chicago, IL 60618-1784 | 2020-09-22 |
| 1013523984 | Antionette Fisher | Counselor | 5703 S Peoria St, Chicago, IL 60621-2262 | 2020-09-16 |
| 1114532561 | Nefesh Counseling, LLC | Counselor | 3320 W Foster Ave # 124, Chicago, IL 60625-4813 | 2020-09-12 |
| 1114531043 | Katherine E Evans | Counselor | 1528 W Jonquil Ter Unit 2c, Chicago, IL 60626-5932 | 2020-09-08 |
| Find all providers in CHICAGO | ||||
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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.