Individual provider Active NPI

Dana Marie Sullivan, M.A., BCBA

  • Behavior Analyst
  • Philadelphia, PA
National Provider Identifier
1023583127
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-18-32578
Practice address
312 S Chadwick St # 2R
Philadelphia, PA 19103-6706
Phone
(267) 467-6599
NPI assigned
Oct 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-18-32578 Primary

Addresses

Primary practice location

312 S Chadwick St # 2R
Philadelphia, PA 19103-6706

Mailing address

312 S Chadwick St # 2R
Philadelphia, PA 19103-6706
Phone (732) 453-4772

Other practice location 1

140 Terry Dr Ste 105
Newtown, PA 18940-1896
Phone (215) 704-9224

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
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Behavioral Connections LLC Behavior Analyst CurrentSince Jan 15, 2023 Accepting new patients
K.W. Behavioral Consulting, LLC Behavior Analyst Past Accepting new patients
Elevated Kids Behavior Analyst PastSince Apr 1, 2023 Accepting new patients

Organizations & group practices 3

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": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1023583127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 S CHADWICK ST # 2R",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036706",
            "telephone_number": "732-453-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S CHADWICK ST # 2R",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036706",
            "telephone_number": "267-467-6599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Terry Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "PA",
            "postal_code": "189401896",
            "country_code": "US",
            "telephone_number": "215-704-9224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.A., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-18-32578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.