Individual provider Active NPI

Maureen Rose Sullivan

  • Mental Health Counselor
  • Braintree, MA
National Provider Identifier
1447765854
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
422 Issued in HI
Practice address
32 Linden St
Braintree, MA 02184-2033
Phone
(808) 345-8477
Fax
(808) 345-8477
NPI assigned
Dec 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 422 HI Primary

Addresses

Primary practice location

32 Linden St
Braintree, MA 02184-2033

Mailing address

32 Linden St
Braintree, MA 02184-2033
Phone (808) 345-8477

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

State licenses

LicenseStateTypeSpecialty
422HIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512604800000",
    "number": "1447765854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 LINDEN ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842033",
            "telephone_number": "808-345-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 LINDEN ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842033",
            "telephone_number": "808-345-8477",
            "fax_number": "808-345-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MAUREEN",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2017-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "HI",
            "license": "422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; 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.