MANDY SULLIVAN (NPI# 1982960431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YP2500X |
Counselor Specialization: Professional |
002169 | CT | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | 004236338 | 05 |
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 |
Street Address |
635 MAIN ST |
City | MIDDLETOWN |
State | CT |
Zip Code | 06457-2718 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 06457 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
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 |
City | MIDDLETOWN |
Zip Code | 06457 |
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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.