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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
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 |
Street Address |
909 E STATE BLVD |
City | FORT WAYNE |
State | IN |
Zip Code | 46805-3404 |
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 |
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 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 |
---|---|---|---|---|
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 |
City | FORT WAYNE |
Zip Code | 46805 |
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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.