Active NPI
Richard John Sullivan Jr.
- Professional Counselor
- Santa Cruz, CA
National Provider Identifier
1497488001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 14953
- Practice address
- 380 Encinal St Ste 200
Santa Cruz, CA 95060-2178 - Phone
- (831) 469-1700
- Fax
- (831) 425-1905
- NPI assigned
- Jul 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Community Health Worker | 172V00000X | |||
| Professional Counselor | 101YP2500X | 14953 | CA | Primary |
Addresses
Primary practice location
380 Encinal St Ste 200
Santa Cruz, CA 95060-2178
Mailing address
380 Encinal St Ste 200
Santa Cruz, CA 95060-2178
Phone (831) 469-1700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Mental Health Counselor
- San Jose, CA
- NPI 1154994846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1497488001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 ENCINAL ST STE 200",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950602178",
"telephone_number": "831-469-1700",
"fax_number": "831-425-1905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 ENCINAL ST STE 200",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950602178",
"telephone_number": "831-469-1700",
"fax_number": "831-425-1905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "RICHARD",
"middle_name": "JOHN",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-01",
"last_updated": "2023-11-13",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "14953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Cruz, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.