Kelly Sullivan, CAC III, QMAP, BA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

ACC.0006756 Issued in CO

Practice address

4856 Innovation Dr
Fort Collins, CO 80525-5539

Phone

(970) 494-4200

Fax

(844) 270-1824

NPI assigned

Sep 19, 2013

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

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1093141178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "844-270-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255539",
            "telephone_number": "970-494-4200",
            "fax_number": "844-270-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KELLY",
        "credential": "CAC III, QMAP,  BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACC.0006756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Rae Suiter
• Suites Fort Collins LLC (The Suites Fort Collins)
• Daira Suljovic, LPCC, MA
• Donna L Sullivan, M.D.
• Hadleigh Anne Sullivan
• Laura Sullivan, RN
• Mary Sullivan, MFT
• Sharyl Sullivan, PTA
• Wendy Sultzman, OTR
• Alyse Kathleen Sumanis

• Addiction (Substance Use Disorder) Counselor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Addiction (Substance Use Disorder) Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.