Active NPI
Robin Lee Sullivan, LADC, PLMHP
- Mental Health Counselor
- Omaha, NE
National Provider Identifier
1558827980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11634
- Practice address
- 4102 Woolworth Ave
Omaha, NE 68105-1851 - Phone
- (402) 444-7000
- NPI assigned
- Feb 11, 2019
- Last updated
- Feb 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11634 | NE | Primary |
Addresses
Primary practice location
4102 Woolworth Ave
Omaha, NE 68105-1851
Mailing address
13110 Grand Ave
Omaha, NE 68164-1732
Phone (402) 686-6947
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11634 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1558827980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13110 GRAND AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681641732",
"telephone_number": "402-686-6947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051851",
"telephone_number": "402-444-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "ROBIN",
"middle_name": "LEE",
"credential": "LADC, PLMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-11",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "11634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.