Individual provider Active NPI

Holly Therese Sullivan

  • Rehabilitation Counselor
  • Buffalo, NY
National Provider Identifier
1356909238
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation CounselorTaxonomy code 225C00000X
Practice address
1050 Niagara St
Buffalo, NY 14213-2007
Phone
(716) 884-0700
Fax
(716) 884-0631
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X NY Primary

Addresses

Primary practice location

1050 Niagara St
Buffalo, NY 14213-2007

Mailing address

1050 Niagara St
Buffalo, NY 14213-2007
Phone (716) 884-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260511000842 NC Practitioner - Clinical Social Worker 0143798926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5221 Paramount Pkwy
Suite 420
Morrisville, NC 27560-4704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1356909238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132007",
            "telephone_number": "716-884-0700",
            "fax_number": "716-884-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 NIAGARA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142132007",
            "telephone_number": "716-884-0700",
            "fax_number": "716-884-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "HOLLY",
        "middle_name": "THERESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.