Individual provider Active NPI

Caitlin Sullivan

  • Mental Health Counselor
  • Hyannis, MA
National Provider Identifier
1417553462
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
100 Independence Dr
Hyannis, MA 02601
Phone
(508) 790-5780
NPI assigned
Dec 7, 2020
Last updated
Dec 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

100 Independence Dr
Hyannis, MA 02601

Mailing address

19 Sheaffer Rd
Centerville, MA 02632-2034

Other practice location 1

19 Sheaffer Rd
Centerville, MA 02632
Phone (508) 280-0082

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 5082800082 Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1417553462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SHEAFFER RD",
            "city": "CENTERVILLE",
            "state": "MA",
            "postal_code": "026322034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INDEPENDENCE DR",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "02601",
            "telephone_number": "508-790-5780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Sheaffer Rd",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "MA",
            "postal_code": "02632",
            "country_code": "US",
            "telephone_number": "508-280-0082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CAITLIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "5082800082",
            "affiliation": "N",
            "endpointDescription": "cell",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "19 Sheaffer Rd",
            "city": "Centerville",
            "state": "MA",
            "country_code": "US",
            "postal_code": "02632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.