Lauren Sullivan, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F403519 Issued in NY

Practice address

10 Stonewall Dr
Queensbury, NY 12804-7719

Phone

(617) 680-1093

NPI assigned

Nov 6, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Behavioral Health Services North, Inc.Group PAC ID 3173511557, 68 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morrisonville, NY
  • NPI 1689621468
  Medicare reassignment Care Compare group NPD
• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Queensbury, NY
  • NPI 1447005541
  NPD
• Saratoga County

  • Home Health Agency
  • Saratoga Springs, NY
  • NPI 1497752158
  NPD (past)
• Saratoga County

  • Community/Behavioral Health Agency
  • Saratoga Springs, NY
  • NPI 1700912367
  NPD (past)

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623542400000",
    "number": "1285147850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 STONEWALL DR",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047719",
            "telephone_number": "617-680-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STONEWALL DR",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047719",
            "telephone_number": "617-680-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAUREN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2021-06-13",
        "certification_date": "2021-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F403519",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "732271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Mary Strother
• Andrew Stuart, LMHC
• Lynn Stumbaugh, COTA
• Toni Marie Sturm, MD
• Janet Susan Stutzman, TSHH
• Summit Imaging Corporation
• Support-Link, Inc.
• Adam Swenson
• Tackett Chiropractic, P.C.
• William B Tackett, DC

• Psychiatric/Mental Health Nurse Practitioner in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; 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.