Michelle Lee Sullivan, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004894 Issued in VA

Practice address

2305 N Parham Rd
Suite 3
Richmond, VA 23229-3156

Phone

(804) 270-1124

Fax

(804) 270-2090

NPI assigned

Jul 8, 2005

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

Other names 1

• Michelle Lee Adams Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dominion Behavioral HealthcareGroup PAC ID 6709803570, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Dominion Behavioral Healthcare

  • Clinical Psychologist
  • Richmond, VA
  • NPI 1043262215
  Medicare reassignment Care Compare group NPD
• Dominion Behavioral Healthcare

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1427075449
  NPD

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1235137894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 N PARHAM RD",
            "address_2": "SUITE 3",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293156",
            "telephone_number": "804-270-1124",
            "fax_number": "804-270-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 N PARHAM RD",
            "address_2": "SUITE 3",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232293156",
            "telephone_number": "804-270-1124",
            "fax_number": "804-270-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ADAMS",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandon J Sullivan
• Joe Lowry Sullivan, CP
• Kaitlin Sullivan, MSOT R/L, CBIS
• Kit Tucker Sullivan, DDS
• Michael Sullivan, PMHNP-BC
• Samuel Sullivan, M.D.
• Travis Michael Sullivan, MD
• Summer C Jones LLC
• Hanna Summers
• John Tibbs Summers Jr., M.D.

• Clinical Psychologist in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.