Tracy Lynn Sullivan, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

BBH-LCPC-LIC-18990 Issued in MT

Practice address

723 5TH Ave E Unit B14
Kalispell, MT 59901-5321

Phone

(406) 351-6334

Fax

(406) 300-0426

NPI assigned

Sep 1, 2020

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

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1114531738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 5TH AVE E UNIT B14",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015321",
            "telephone_number": "406-351-6334",
            "fax_number": "406-300-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 5TH AVE E UNIT B14",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599015321",
            "telephone_number": "406-351-6334",
            "fax_number": "406-300-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-LCPC-LIC-18990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael A. Sugarman, MD
• Debra K Sullivan, P.T.
• Janna Marie Sullivan, WHCNP
• Jeffrey P Sullivan, PHARMD
• John Winston Sullivan, PHARM.D.
• Summit Anesthesia Associates PLLC
• Summit Ranch Inc
• Summit Ranch Inc.
• Sunburst Community Service Foundation, Inc
• Jana J Sund, CNM

• Mental Health Counselor in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Mental Health Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.