Sean Sullivan
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Clearlake Oaks, CA
NPI 1356049191 · NPPES record last updated Feb 21, 2023
Key facts
- NPI
- 1356049191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 17429 (CA)
- Practice address
- 14715 E. Hwy 20
Clearlake Oaks, CA 95423 - Phone
- (707) 998-1800
- Fax
- (707) 998-0122
- NPI assigned
- Feb 21, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hilltop Recovery Services | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17429 | CA | Yes |
Addresses
Primary practice location
14715 E. Hwy 20
Clearlake Oaks, CA 95423
Mailing address
PO Box 366
Clearlake Oaks, CA 95423-0366
Phone (707) 998-1800
Other providers in Clearlake Oaks, CA
- Daylen Cecil Roberts
- Rikki Irie Ruiz
- Patricia V Santacruz
- John Phillip Sheridan
- Darcy Towner Skarada
- Zakai Taurence Vilmenay I
- Kathryn Wickard
All providers in Clearlake Oaks, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.