Nicole Ann Sullivan

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

56 W Main St
Plainville, CT 06062-1904

Phone

(860) 351-5407

NPI assigned

Nov 13, 2018

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1306314927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 TOWER RD",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422830",
            "telephone_number": "860-803-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 W MAIN ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621904",
            "telephone_number": "860-351-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Greenwood St Ste A",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016071767",
            "country_code": "US",
            "telephone_number": "508-363-0200",
            "fax_number": "508-363-1213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsullivan@iasautism.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "56 W Main St",
            "city": "Plainville",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060621904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Stewart
• Melissa M Stewart, M.A.
• Marla Stoddard
• Evelisa Stokes
• Debra Ann Stueber-Ward
• Michele Marie Sutliffe, MS,MA
• Jessica Anna Suwala
• Melissa Sweeney, LCSW
• Nicole Symonovich
• Teresa M Szajda, MD

• Developmental Therapist in Plainville, CT
• Providers in Plainville, CT by specialty
• Developmental Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.