Bernard J Sullivan PHD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP-0436 Issued in KS

Legal business name

BERNARD J SULLIVAN PHD LLC

Practice address

10540 Marty St Ste 155
Overland Park, KS 66212-2654

Phone

(913) 451-2843

Fax

(913) 383-1088

NPI assigned

Mar 20, 2007

Last updated

Dec 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bernard John Sullivan, PH.D.NPI 1528184306

Title

Member

Phone

(913) 451-2843

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bernard John Sullivan, PH.D.

  • Clinical Psychologist
  • Overland Park, KS
  • NPI 1528184306
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1528183159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10540 MARTY ST STE 155",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662122654",
            "telephone_number": "913-451-2843",
            "fax_number": "913-383-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10540 MARTY ST STE 155",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662122654",
            "telephone_number": "913-451-2843",
            "fax_number": "913-383-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNARD J SULLIVAN PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "913-451-2843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "LP-0436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bergner Chiropractic, LLC
• Luke Edward Bergner, DC
• Marissa Bergthold, DDS
• Sarah Berke
• Celina C Bernabe, DO
• Jennifer P Bernard, M.D.
• John R Bernard, M.D.
• Jeanette M Bernhard
• Alec Bernstein, M.A., BCBA
• Vanessa Berrey

• Clinical Psychologist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.