Individual provider Active NPI

Paula J Varnado-Sullivan, PH.D

  • Clinical Psychologist
  • Baton Rouge, LA
National Provider Identifier
1003877374
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
821 Issued in LA
Practice address
740 Colonial Dr
Baton Rouge, LA 70806-6511
Phone
(225) 216-9422
Fax
(225) 216-1260
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 821 LA Primary

Addresses

Primary practice location

740 Colonial Dr
Baton Rouge, LA 70806-6511

Mailing address

740 Colonial Dr
Baton Rouge, LA 70806-6511
Phone (225) 216-9422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
821LAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
CDC Associates, LLC Clinical Past Accepting new patients
Rd Associates, LLC Clinical Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1003877374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 COLONIAL DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066511",
            "telephone_number": "225-216-9422",
            "fax_number": "225-216-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 COLONIAL DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066511",
            "telephone_number": "225-216-9422",
            "fax_number": "225-216-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNADO-SULLIVAN",
        "first_name": "PAULA",
        "middle_name": "J",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.