Active NPI
Anne K. Sullivan, ED.D.
- Clinical Psychologist
- Williamsburg, VA
National Provider Identifier
1235173386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810001763
- Practice address
- 1769 Jamestown Rd
Suite R
Williamsburg, VA 23185-2307 - Phone
- (757) 564-7002
- Fax
- (757) 229-4343
- NPI assigned
- Jun 16, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810001763 | VA | Primary |
Addresses
Primary practice location
1769 Jamestown Rd
Suite R
Williamsburg, VA 23185-2307
Mailing address
1769 Jamestown Rd
Suite R
Williamsburg, VA 23185-2307
Phone (757) 564-7002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 242538 | Other | VA | ANTHEM |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1235173386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1769 JAMESTOWN RD",
"address_2": "SUITE R",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231852307",
"telephone_number": "757-564-7002",
"fax_number": "757-229-4343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1769 JAMESTOWN RD",
"address_2": "SUITE R",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231852307",
"telephone_number": "757-564-7002",
"fax_number": "757-229-4343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "ANNE",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810001763",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "242538",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsburg, VA
- Sarah Stulen, DDS
- Sarita Golikeri Subramaniam, MD
- Vijay Subramaniam, M.D.
- Success in Mind of Virginia LLC (Success Behavioral Health Services)
- Carina Sudarsky-Gleiser, PH.D.
- Robert E Sullivan
- Carter Wheeler Summerville
- Summit Medical Consultants, LLC
- Kory Supplee
- Supreme Helpers Healthcare Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.