Stephanie Sullivan, PHD, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5518 Issued in MA

Practice address

780 Albany St
Boston, MA 02118-2755

Phone

(857) 654-1002

NPI assigned

Sep 1, 2022

Last updated

Sep 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stephanie Collins Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Mental Health Counselor

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Health Services, LLC

  dba Hyland Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1225067481
  Medicare reassignment Care Compare group NPD
• Boston Health Care for the Homeless Program, Inc.

  dba BHCHP Pharmacy

  • Community/Retail Pharmacy
  • Boston, MA
  • NPI 1194443531
  NPD (past)

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1417677105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 HARTNESS RD",
            "city": "SUTTON",
            "state": "MA",
            "postal_code": "015904815",
            "telephone_number": "508-865-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ALBANY ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182755",
            "telephone_number": "857-654-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "STEPHANIE",
        "credential": "PHD, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "5518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "S20079445",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Clinic",
            "affiliation": "Y",
            "affiliationName": "Boston Health Care for the Homeless Program, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "780 Albany St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021182755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "COLLINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Penelope N Sullivan, PT
• Roberta M. Sullivan I
• Ryan P Sullivan, MD
• Sara Hamilton Sullivan, M.D.
• Stacey Lynn Sullivan, MS, CCC-SLP
• William M Sullivan, M.D.
• Stephanie Sullo, AU.D.
• Joan Sully, NP
• Ashley Cameron Sultan
• Rana Sultan

• Mental Health Counselor in Boston, MA
• Providers in Boston, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.