Marsharne J. Sullivan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

06223082 Issued in GA

Practice address

4981 Phillips Dr
Forest Park, GA 30297-1401

Phone

(404) 997-3487

NPI assigned

May 24, 2023

Last updated

Jun 5, 2023By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1174215503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4981 PHILLIPS DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971401",
            "telephone_number": "404-997-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4981 PHILLIPS DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302971401",
            "telephone_number": "404-997-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARSHARNE",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "06223082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.