Sharlene Mary Sullivan, MA LDAC1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

789 Issued in MA

Practice address

103 Myron St Ste a
West Springfield, MA 01089

Phone

(413) 592-1980

Fax

(413) 439-0100

NPI assigned

Mar 30, 2007

Last updated

Aug 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Sparks Counseling Services, LLC

  • Mental Health Counselor
  • Gardner, MA
  • NPI 1235776329
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1063532372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MYRON ST STE A",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010891485",
            "telephone_number": "413-592-1980",
            "fax_number": "413-439-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MYRON ST STE A",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "01089",
            "telephone_number": "413-592-1980",
            "fax_number": "413-439-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Day Mill Dr",
            "address_purpose": "LOCATION",
            "city": "Templeton",
            "state": "MA",
            "postal_code": "014681472",
            "country_code": "US",
            "telephone_number": "978-939-5603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SHARLENE",
        "middle_name": "MARY",
        "credential": "MA LDAC1",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Strange, MSW INTERN
• Eric S. Strauss, PH.D.
• Jessica R Sullivan, LICSW
• Mary Ryan Sullivan, R.PH.
• Sabra Sullivan, PMHNP-BC
• Susan Sullivan, L.I.C.S.W.
• Sharon L Summers, RN
• Sunnyside Home Care LLC
• Sunshine Village, Inc
• L Elizabeth Sura

• Addiction (Substance Use Disorder) Counselor in West Springfield, MA
• Providers in West Springfield, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.