Brady Sullivan, LPC, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2018014894 Issued in MO

Practice address

3115 S Grand Blvd Ste 300
Saint Louis, MO 63118-1046

Phone

(314) 339-7356

NPI assigned

May 8, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Brady Sullivan Consulting, LLC

  • Adult Mental Health Clinic/Center
  • Saint Louis, MO
  • NPI 1003551995

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1497244115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 LOUGHBOROUGH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162103",
            "telephone_number": "630-885-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 S GRAND BLVD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181046",
            "telephone_number": "314-339-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRADY",
        "name_prefix": "Dr.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2018014894",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "MO",
            "license": "2018014894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Been Suk, DO
• Nitin Sukumar
• Lynn Marie Sullinger, D.P.T
• Aja Blue Sullivan, RN
• Amanda Leigh Sullivan, MS, ATC
• Christine Sullivan
• Conor Michael Sullivan
• Daniel T. Sullivan, D.D.S.
• Elise Sullivan
• Elizabeth C Sullivan, OT

• Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.