TIMOTHY O'SULLIVAN


Address: 909 E State Blvd, Fort Wayne, IN 46805-3404
Phone: 2604812700

TIMOTHY O'SULLIVAN (NPI# 1871986026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871986026
Entity Type Individual
Full Name TIMOTHY O'SULLIVAN
Credential MA
Practice Address 909 E State Blvd
Fort Wayne
IN 46805-3404
Practice Telephone 2604812700
Practice Fax Number 2604812709
Mailing Telephone 2604812700
Mailing Fax Number 2604812709
Enumeration Date 2015-03-12
Last Update Date 2015-03-12
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101Y00000X Counselor Behavioral Health & Social Service Providers

Other Providers TIMOTHY O'SULLIVAN

NPI Name Taxonomy Address Enumeration
1912430687 Timothy O'sullivan Student in an Organized Health Care Education/Training Program 150 Bergen St, Uh-i248, Internal Medicine Residency Program, Newark, NJ 07103-2496 2017-04-09

Office Location

Street Address 909 E STATE BLVD
City FORT WAYNE
State IN
Zip Code 46805-3404

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689664419 Richard A Horstmeyer Family Medicine 909 E State Blvd, Fort Wayne, IN 46805-3404 2005-10-24
1174132674 Rachel Lee Taykowski Social Worker 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-07-30
1831708510 Alexandra Leroy Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-07-28
1881203560 Timothy James Prentice Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-07-28
1922617620 Elise S. Beech Social Worker 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-07-28
1457972481 David D Hibish Case Manager/Care Coordinator 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-04-30
1790317667 Jill Elizabeth Surine Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-02-10
1851923627 Emily Redman Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-02-10
1912537325 Estrella Devia Case Manager/Care Coordinator 909 E State Blvd, Fort Wayne, IN 46805-3458 2020-01-24
1083252548 Amber Ginet O'daniels Counselor 909 E State Blvd, Fort Wayne, IN 46805-3458 2019-12-16
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619589546 Connor Gemlick Student in an Organized Health Care Education/Training Program 1918 Carew St., Fort Wayne, IN 46805 2020-08-21
1710464086 S.t.a.r. Care Services Clinic/Center 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 2018-07-19
1083122865 Noel Shafi Counselor 3010 East State Boulevard, Fort Wayne, IN 46805 2018-01-16
1063963627 Toni L Irby Specialist 3219 E State Blvd, Fort Wayne, IN 46805 2016-10-19
1639626211 Logan Schwerer Pharmacist 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 2016-09-01
1063817104 Michale Diane Rothgeb Physical Therapy Assistant 2200 Randollia Dr, Fort Wayne, IN 46805 2014-10-31
1124435789 Julia I. Mcfann Physical Therapist 2200 Randalia Dr, Fort Wayne, IN 46805 2014-07-16
1083036974 Capital Senior Living Properties 4, Inc. Assisted Living Facility 3320 East State Boulevard, Fort Wayne, IN 46805 2014-01-10
1356772396 Alexander James Medical Supply Durable Medical Equipment & Medical Supplies 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 2013-12-02
1043595689 Randy James Jennings Pharmacist 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 2011-10-14
Find all providers in zip 46805

Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114401080 Robin Gene Vandeventer Counselor 2200 Lake Ave Ste 225, Fort Wayne, IN 46805-5364 2018-09-18
1023544533 Emily Martin Counselor 4646 W Jefferson Blvd Ste 100, Fort Wayne, IN 46804-6832 2017-05-03
1467995035 Heather Sue Bleeke Counselor 830 Ivy Creek Cv, Fort Wayne, IN 46804-3581 2016-11-29
1437604014 Donald Luedke Counselor 427 W Washington Blvd, Fort Wayne, IN 46802-2915 2016-08-24
1306208400 Tracy Cain Counselor 431 Fairmont Place, Fort Wayne, IN 46808-1116 2016-03-28
1144600982 Megan Kostrubanic Counselor 2420 N Coliseum Blvd Ste 206, Fort Wayne, IN 46805-3139 2015-06-07
1336579754 Interdisciplinary Community Autism Network, Inc Counselor 409 E Cook Rd, Suite 100, Fort Wayne, IN 46825-3600 2013-11-21
1477823151 Gregory Wayne Isch Counselor 7230 Engle Rd Ste 305, Fort Wayne, IN 46804 2012-01-11
1710120753 Sandra Thomas Counselor 5440 Thornbriar Ln, Fort Wayne, IN 46835-3886 2009-04-07
1508034091 John Patrick Nolan Counselor 6015 Dichotomy Ct, Fort Wayne, IN 46835-2063 2008-02-18
Find all providers in FORT WAYNE

Competitor

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City FORT WAYNE
Zip Code 46805

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Dataset Information

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.

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