Active NPI
Zennie L Sullivan
- Professional Counselor
- Toledo, OH
National Provider Identifier
1346740156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 5565 Airport Hwy Ste 100
Toledo, OH 43615-7391 - Phone
- (419) 720-5800
- Fax
- (419) 720-4444
- NPI assigned
- Feb 19, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C.1801021 | OH | |
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
5565 Airport Hwy Ste 100
Toledo, OH 43615-7391
Mailing address
1015 Virginia St
Toledo, OH 43606-4624
Phone (567) 202-7813
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.1801021 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Professional | Current | Accepting new patients |
| The Willow Center | Past | Accepting new patients |
Interoperability endpoints
- zenniesullivan@tdh.allscriptsdirect.net
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Professional
-
- Community/Behavioral Health Agency
- Toledo, OH
- NPI 1336596550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1518998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1346740156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 VIRGINIA ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436064624",
"telephone_number": "567-202-7813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5565 AIRPORT HWY STE 100",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436157391",
"telephone_number": "419-720-5800",
"fax_number": "419-720-4444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "ZENNIE",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-19",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "C.1801021",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.