Active NPI
Brandon Kai Sullivan, RADT
- Addiction (Substance Use Disorder) Counselor
- Anaheim, CA
National Provider Identifier
1154913267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R141757121
- Practice address
- 527 S Archer St
Anaheim, CA 92804-2421 - Phone
- (404) 748-3372
- NPI assigned
- Feb 9, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R141757121 | CA | Primary |
Addresses
Primary practice location
527 S Archer St
Anaheim, CA 92804-2421
Mailing address
527 S Archer St
Anaheim, CA 92804-2421
Phone (404) 748-3372
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
| License | State | Type | Specialty |
|---|---|---|---|
| R141757121 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612828800000",
"number": "1154913267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "527 S ARCHER ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928042421",
"telephone_number": "404-748-3372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "527 S ARCHER ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928042421",
"telephone_number": "404-748-3372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "BRANDON",
"middle_name": "KAI",
"credential": "RADT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-09",
"last_updated": "2021-02-09",
"certification_date": "2021-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R141757121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.