Jane Mary Sullivan, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024182114 Issued in VA

Practice address

1005 N Glebe Rd Ste 525
Arlington, VA 22201-5792

Phone

(804) 207-6737

NPI assigned

Mar 3, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lifestancehealth.janesullivan@144557.advancedmd-direct.com

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

• Commonwealth Counseling Associates Inc

  • Clinical Psychologist
  • Mechanicsville, VA
  • NPI 1851345805

  DC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1144490491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 N GLEBE RD STE 525",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222015792",
            "telephone_number": "804-207-6737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N GLEBE RD STE 525",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222015792",
            "telephone_number": "804-207-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "JANE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2023-07-20",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "163877",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024182114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "163877",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shree Subhash, M.D.
• Elizabeth Ann Suellentrop, MSW
• Kaitlyn Payne Sugden, FNP
• Pride Suh
• Alexandra Grace Fellows Sullivan, LCSW
• Lucy Mackinnon Sullivan
• Mark Ford Sullivan, M.D.
• Michele Martin Sullivan, RN
• Zain Jalal Sultan, MD
• Kevin D Sumida, MD

• Psychiatric/Mental Health Nurse Practitioner in Arlington, VA
• Providers in Arlington, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.