Individual provider Active NPI

Christy Sullivan, LPC, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Carrboro, NC
National Provider Identifier
1073649984
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
413 Issued in NC
Practice address
410 N. Greensboro St. S
Suite 220
Carrboro, NC 27510-1870
Phone
(919) 966-9803
Fax
(919) 966-9169
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4383 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X 413 NC Primary

Addresses

Primary practice location

410 N. Greensboro St. S
Suite 220
Carrboro, NC 27510-1870

Mailing address

410 N. Greensboro St. S
Suite 220
Carrboro, NC 27510-1870
Phone (919) 966-9803

Other identifiers 1

IdentifierTypeStateIssuer
6102909MedicaidNC

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

State licenses

LicenseStateTypeSpecialty
413NCMDPrimary Podiatric Medicine Podiatrist
4383NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1073649984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N. GREENSBORO ST. S",
            "address_2": "SUITE 220",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101870",
            "telephone_number": "919-966-9803",
            "fax_number": "919-966-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N. GREENSBORO ST. S",
            "address_2": "SUITE 220",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101870",
            "telephone_number": "919-966-9803",
            "fax_number": "919-966-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CHRISTY",
        "credential": "LPC, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4383",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102909",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.