Nicole Sullivan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37AC00219500 Issued in NJ

Practice address

160 Atlantic City Blvd
Bayville, NJ 08721-1229

Phone

(732) 349-5550

NPI assigned

Mar 14, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ocean Mental Health Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bayville, NJ
  • NPI 1508884347
  Medicare reassignment NPD

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

{
    "created_epoch": "1426291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437542404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ATLANTIC CITY BLVD",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "087211229",
            "telephone_number": "732-349-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ATLANTIC CITY BLVD",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "087211229",
            "telephone_number": "732-349-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "NICOLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00594000",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00219500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ BOARD OF MARRIAGE AND FAMILY  THERAPY EXAMINERS",
            "identifier": "37PC00594000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Sikorski, LCSW
• Alysha Rose Simmons, LSW
• Sheryl A Slonim, NP-C
• Teodora Solotchi, PHARMD
• Brianna Starkey, LCSW
• Chris Taduran, RPH
• Lamberto A. Tan, M.D.
• Renuka H. Tank, M.D.
• Michelle Tarantino, MS OTR/L
• Katrina Amelia Tenor, LSW

• Professional Counselor in Bayville, NJ
• Providers in Bayville, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.