Mandy J Sullivan, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

4704354660 Issued in MI

Practice address

750 Towner St
Ypsilanti, MI 48198-5724

Phone

(734) 544-3000

NPI assigned

Nov 20, 2019

Last updated

Nov 20, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Washtenaw

  dba Washtenaw county Public Health

  • State or Local Public Health Clinic/Center
  • Ypsilanti, MI
  • NPI 1609896018
  NPD (past)
• County of Washtenaw

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ypsilanti, MI
  • NPI 1639132442
  NPD (past)

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1285270694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985723",
            "telephone_number": "734-323-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 TOWNER ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985724",
            "telephone_number": "734-544-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 N 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481045503",
            "country_code": "US",
            "telephone_number": "734-222-3750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MANDY",
        "middle_name": "J",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704354660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marwa Sulaiman
• Suzzanne Suleiman, LLP
• Staci Suliman, MSW
• Brendan Sullivan
• Humayra Nikhat Sullivan, MD
• Ahlam Sultan
• Lori Summers
• Anupam Suneja, MD
• Jinhee Sung
• Superior One Home Care

• Adult Psychiatric/Mental Health Registered Nurse in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.