Active NPI
Kathleen Marie Sullivan, LMFT
- Marriage & Family Therapist
- Brookfield, CT
National Provider Identifier
1174739197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 000810
- Practice address
- 5 Junction Rd
Brookfield, CT 06804-3414 - Phone
- (203) 775-6997
- Fax
- (203) 775-0389
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 000810 | CT | Primary |
Addresses
Primary practice location
5 Junction Rd
Brookfield, CT 06804-3414
Mailing address
5 Junction Rd
Brookfield, CT 06804-3414
Phone (203) 775-6997
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 |
|---|---|---|---|
| 000810 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174739197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 JUNCTION RD",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068043414",
"telephone_number": "203-775-6997",
"fax_number": "203-775-0389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 JUNCTION RD",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068043414",
"telephone_number": "203-775-6997",
"fax_number": "203-775-0389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "KATHLEEN",
"middle_name": "MARIE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "000810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, CT
- Stony Run Medical Corporation
- Megan N Strand
- James Stringer, RPH
- Strong Together Counseling LLC
- James Michael Sullivan, PHD
- Summit Fitness & Rehabilitation, LLC
- Support: You
- Leslie Tan, LMHC
- The Blue Butterfly Beyond Autism LLC
- The Brookfield Volunteer Fire Company Inc (Brookfield Volunteer Fire Co., Inc.)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.