Active NPI
Dolores Arlt Sullivan, SLP
- Speech-Language Pathologist
- St. Michaels, AZ
National Provider Identifier
1275757460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4028
- Practice address
- 1 Mi N of 264 Mustang Road
St. Michaels, AZ 86511-0100 - Phone
- (928) 871-2822
- Fax
- (928) 871-2837
- NPI assigned
- Apr 12, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4028 | AZ | Primary |
Addresses
Primary practice location
1 Mi N of 264 Mustang Road
St. Michaels, AZ 86511-0100
Mailing address
PO Box 3327
Gallup, NM 87305-3327
Phone (505) 863-8887
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 921280 | Medicaid | AZ | |
| AZ0308030 | Other | AZ | BLUE CROSS BLUE SHIELD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275757460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3327",
"city": "GALLUP",
"state": "NM",
"postal_code": "873053327",
"telephone_number": "505-863-8887",
"fax_number": "928-871-2837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MI N OF 264 MUSTANG ROAD",
"city": "ST. MICHAELS",
"state": "AZ",
"postal_code": "865110100",
"telephone_number": "928-871-2822",
"fax_number": "928-871-2837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "DOLORES",
"middle_name": "ARLT",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "4028",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "921280",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0308030",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in St. Michaels, AZ
- Professional Behavioral Health Services of St. Michaels (Professional Counseling Services)
- Sacred Mountain Home Care
- Sacred Sun Transport
- Sequel Tsi of Az, LLC (Traditions St. Michaels)
- St. Michaels Association for Special Education
- Terricena Ajramirez (@ Heart Home Care)
- Traditional Home Care
- Norma Jean Tsosie
- Vista Care, LLC
- Leah Marie West, PT
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.