Merry C Sullivan, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60324864 Issued in WA

Practice address

920 S 2ND St
Mount Vernon, WA 98273-4205

Phone

(360) 428-6141

NPI assigned

May 7, 2007

Last updated

Jan 16, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• City of Mount Vernon School Dist 320

  • Local Education Agency (LEA)
  • Mount Vernon, WA
  • NPI 1467486159
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1053524173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20366 ERIC ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982747736",
            "telephone_number": "360-424-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S 2ND ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982734205",
            "telephone_number": "360-428-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MERRY",
        "middle_name": "C",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00006054",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60324864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Strong, MD
• Darlene Stuber
• Mark A Studley, MD
• Dana Sturtz, DPT, GCS
• Ashoka Subedar, DMD
• Glen Mark Sumagit
• Christine L Sundholm, SUDP
• Sunrise Services, Inc.
• Sunrise Services, Inc.
• Sunrise Services, Inc.

• Speech-Language Pathologist in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.