MANDY SULLIVAN


Address: 635 Main St, Middletown, CT 06457-2718
Phone: 8603476971

MANDY SULLIVAN (NPI# 1982960431) 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) 1982960431
Entity Type Individual
Full Name MANDY SULLIVAN
Credential LPC
Practice Address 635 Main St
Middletown
CT 06457-2718
Mailing Address 575 Main St Fl 2
Attn: Credentialing Dpt
Middletown
CT 06457-2845
Practice Telephone 8603476971
Practice Fax Number 8607048034
Mailing Telephone 8603476971
Enumeration Date 2012-04-10
Last Update Date 2012-04-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
002169 CT Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT 004236338 05

Other Providers MANDY SULLIVAN

NPI Name Taxonomy Address Enumeration
1285270694 Mandy J Sullivan Registered Nurse 750 Towner St, Ypsilanti, MI 48198-5724 2019-11-20
1992006621 Mandy Jo Sullivan Behavioral Analyst 20 N 13th St, Murphysboro, IL 62966-2057 2010-11-11

Office Location

Street Address 635 MAIN ST
City MIDDLETOWN
State CT
Zip Code 06457-2718

Providers in the same location

NPI Name Taxonomy Address Enumeration
1144226390 R. Timothy Kearney Psychologist 635 Main St, Middletown, CT 06457-2718 2005-06-22
1750842555 Shannon Katherine Rouse Marriage & Family Therapist 635 Main St, Middletown, CT 06457-2718 2019-03-26
1316489313 Maria Teresa Machado Dental Hygienist 635 Main St, Middletown, CT 06457-2718 2016-11-08
1528518693 Tara Nicole Tremblay Dental Hygienist 635 Main St, Attn: Credentialing Dpt, Middletown, CT 06457-2718 2016-10-12
1083980957 Christine Foley Psychologist 635 Main St, Middletown, CT 06457-2718 2012-03-26
1437435419 Sandra Dawn Fomenko Nurse Practitioner 635 Main St, Middletown, CT 06457-2718 2011-10-22
1770814105 Luz Hago Dietitian, Registered 635 Main St, Middletown, CT 06457-2718 2010-01-25
1598092561 Julie B Nash Psychologist 635 Main St, Middletown, CT 06457-2718 2009-11-11
1073761821 Nancy Trouern Trend Registered Nurse 635 Main St, Middletown, CT 06457-2718 2008-09-05
1447413646 Kimberly Fournier Social Worker 635 Main St, Middletown, CT 06457-2718 2008-07-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699391961 Meghan Harrington Behavior Technician 101 Centerpoint Drive #243, Middletown, CT 06457 2020-06-22
1427619626 Collaborative Aba Services, LLC Behavioral Analyst 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 2019-06-27
1376100339 Kimberly Tynik Pharmacist 451 Fowler Ave, Middletown, CT 06457 2019-05-24
1184101263 Tabrez Adil Dentist 675 Main St., Middletown, CT 06457 2018-07-23
1326535337 Rehan Khan Non-emergency Medical Transport (VAN) 765 Country Club Rd, Middletown, CT 06457 2018-04-16
1366950206 State of Connecticut Psychiatric Hospital 70 O'brien Drive, Middletown, CT 06457 2018-01-12
1902324536 Cynthia Tine Physical Therapy Assistant 628 Congdon Street, Middletown, CT 06457 2017-09-04
1619494390 Nathan Douglas Roy Specialist/Technologist 431 Briarwood Lane, Middletown, CT 06457 2017-08-24
1598286502 Rachel Hoffman Whelen Registered Nurse 420 Saybrook Road, Suite A, Middletown, CT 06457 2017-06-29
1003358326 Rebecca Rotondo Social Worker 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 2016-11-17
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669086799 Berry Family Psychotherapy, LLC Counselor 27 White Rd, Middletown, CT 06457-2321 2020-09-05
1114555851 Demetrius Valentino Mckay Counselor 326 Acasta Dr, Middletown, DE 19709-9800 2020-03-30
1740813047 Shayne Jervey Ahmad Counselor 292 Carter Dr Ste Aandb, Middletown, DE 19709-5846 2020-02-15
1801439427 Edwin Dejesus Counselor 31 Peyton Pl, Middletown, CT 06457-2339 2019-10-27
1457817678 Nicole Elizabeth Mchugh Counselor 360 Main St Ste 2d, Middletown, CT 06457-3375 2019-02-12
1801370978 Nicole Fodaski Counselor 1428 Millbrook Rd, Middletown, CT 06457-5538 2018-09-24
1740789163 Corinne Ruppert Counselor 215 Oberlin Rd, Middletown, PA 17057-1448 2018-02-12
1881102499 Chelsea Dicicco Counseling Services LLC Counselor 360 Main St Ste 2b, Middletown, CT 06457-3375 2018-01-17
1164938593 Chelsea Rose Dicicco Counselor 29 Fairlawn Ave, Middletown, CT 06457-5315 2017-12-21
1639685456 Integrated Counseling Solutions, LLC Counselor 363 Main St Ste 512, Middletown, CT 06457-3359 2017-12-15
Find all providers in MIDDLETOWN

Competitor

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City MIDDLETOWN
Zip Code 06457

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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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