Elizabeth Gral Sullivan, MS/CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

878-154 Issued in WI

Practice address

13111 North Port Washington Road
Mequon, WI 53097

Phone

(262) 243-7444

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1538103643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 E HYDE WAY",
            "city": "FOX POINT",
            "state": "WI",
            "postal_code": "532173221",
            "telephone_number": "414-352-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 NORTH PORT WASHINGTON ROAD",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53097",
            "telephone_number": "262-243-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ELIZABETH",
        "middle_name": "GRAL",
        "name_prefix": "Mrs.",
        "credential": "MS/CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "878-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Strauss, MS, LAT, ATC
• Amy Beth Streeter, MSCCCSLP
• Jennifer Elizabeth Strom, M.A., LPC
• Susan Doerflinger Sturdevant, LCSW
• Daniel Andrew Sullivan, DDS
• Melissa J Summerfield, MS, LPC
• Support Plus Personal Care
• Susan Doerflinger MSW LCSW Sac LLC
• Andrea Lynn Swanson, MA, LPC-IT
• Brandon Swantz, D.C.

• Speech-Language Pathologist in Mequon, WI
• Providers in Mequon, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.