Active NPI
Julia Cecile Sullivan, MT-BC
- Music Therapist
- Herndon, VA
National Provider Identifier
1184923427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 09687
- Practice address
- 903 Barker Hill Rd
Herndon, VA 20170-3015 - Phone
- (703) 481-8565
- NPI assigned
- Mar 25, 2011
- Last updated
- Sep 27, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Poetry Therapist | 102X00000X | 09687 | VA | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 09687 | VA | |
| Music Therapist | 225A00000X | 09687 | VA | Primary |
Addresses
Primary practice location
903 Barker Hill Rd
Herndon, VA 20170-3015
Mailing address
903 Barker Hill Rd
Herndon, VA 20170-3015
Phone (703) 481-8565
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 |
|---|---|---|---|
| 09687 | VA | MD | Intellectual & Developmental Disabilities Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348704000000",
"number": "1184923427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 BARKER HILL RD",
"city": "HERNDON",
"state": "VA",
"postal_code": "201703015",
"telephone_number": "703-481-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 BARKER HILL RD",
"city": "HERNDON",
"state": "VA",
"postal_code": "201703015",
"telephone_number": "703-481-8565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JULIA",
"middle_name": "CECILE",
"name_prefix": "Ms.",
"credential": "MT-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-25",
"last_updated": "2012-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "102X00000X",
"taxonomy_group": "",
"desc": "Poetry Therapist",
"state": "VA",
"license": "09687",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "VA",
"license": "09687",
"primary": false
},
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "VA",
"license": "09687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herndon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.