Logan Sullivan

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL017079 Issued in PA

Practice address

38 N Scott St
Carbondale, PA 18407-1888

Phone

(570) 280-2800

NPI assigned

Aug 14, 2023

Sex

Female

Sole proprietor

Yes

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)

Not 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.

• Compass Adult Programs LLC

  • Community/Behavioral Health Agency
  • Carbondale, PA
  • NPI 1851983332
  NPD

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1558044727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 N SCOTT ST",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184071888",
            "telephone_number": "570-280-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 N SCOTT ST",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184071888",
            "telephone_number": "570-280-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LOGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL017079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Marie Spott, DPT
• Michelle Stchur
• Jodi Stearns, LPC
• Jeffrey Steinberg
• Rebecca Stevens
• Elizabeth Ann Svetovich, OTR/L
• Jonathan Symonies
• Nicole Tagliferri
• Tamrat Bekele MD
• The Young Men'S Christian Association of Carbondale

• Speech-Language Pathologist in Carbondale, PA
• Providers in Carbondale, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.