Active NPI
Katelyn E Sullins, MA
- Professional Counselor
- Boerne, TX
National Provider Identifier
1306568548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 89501
- Practice address
- 908 S Main St
Boerne, TX 78006-2635 - Phone
- (830) 375-8484
- NPI assigned
- Sep 14, 2022
- Last updated
- Sep 14, 2022
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 89501 | TX | Primary |
Addresses
Primary practice location
908 S Main St
Boerne, TX 78006-2635
Mailing address
PO Box 964
Boerne, TX 78006-0964
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447984877 | Other | TX | RETROUVAILLE LLC |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 89501 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1306568548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 964",
"city": "BOERNE",
"state": "TX",
"postal_code": "780060964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "908 S MAIN ST",
"city": "BOERNE",
"state": "TX",
"postal_code": "780062635",
"telephone_number": "830-375-8484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLINS",
"first_name": "KATELYN",
"middle_name": "E",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-14",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "89501",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RETROUVAILLE LLC",
"identifier": "1447984877",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
- Gwendolyn Lorraine Stoops, LVN
- Nathan William Storb, PT, DPT, CSRS
- Stratton Hogan Clinics Inc.
- Casey L Straud, PSYD
- Sarah Irene Stricker, LPC
- Christi Sullivan
- Mikaela Mercedes Summerville, RBT
- Summit Bariatric and Robotic Surgical Specialists PLLC
- Scott Sumners, PHARM.D.
- Sunrise Primary Care Services Inc (Crest Home Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.