Amy Watson Sullivan, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

110705 Issued in TX

Practice address

7217 Hawkins View Dr
Fort Worth, TX 76132-3927

Phone

(817) 479-7019

NPI assigned

Jun 12, 2018

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Monkey Ears, LLC

  • Audiologist
  • Southlake, TX
  • NPI 1831706175
  NPD (past)
• Monkey Mouths, PLLC

  • Speech-Language Pathologist
  • Hurst, TX
  • NPI 1164613253
  NPD (past)
• University of Texas at Dallas

  • Audiologist
  • Dallas, TX
  • NPI 1770559973

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1164915435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 BELLAIRE DR N",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761092115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 HAWKINS VIEW DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323927",
            "telephone_number": "817-479-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "AMY",
        "middle_name": "WATSON",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "110705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunjin M Suh, DDS
• Sukhoon Yoon, MD, PA
• Sukrita Bedi Matta DDS, PLLC
• Joachim Albert Sulfrian Jr., LCDC
• Amanda Sullivan
• Caroline Sullivan, RD
• Denise L Sullivan, MD
• Hannah Sullivan
• Julia B Sullivan, RD, LD, MPAS, PA-C
• Kathleen A Sullivan, A.N.P.

• Speech-Language Pathologist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.

Verify at the official NPI Registry.