Michael Sullivan Counseling PC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1464 Issued in NE

Legal business name

MICHAEL SULLIVAN COUNSELING PC

Practice address

110 N 37TH St Ste 301
Norfolk, NE 68701-3283

Phone

(402) 750-7923

NPI assigned

Oct 28, 2008

Organization subpart

No

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

Authorized official

Name

Michael Daniel Sullivan, LCSW, CCGCNPI 1063548139

Title

President

Phone

(402) 750-7923

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

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.

• Michael Daniel Sullivan, LICSW, CDGC

  • Mental Health Counselor
  • Norfolk, NE
  • NPI 1063548139
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1568615128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N 37TH ST STE 301",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013283",
            "telephone_number": "402-750-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 37TH ST STE 301",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013283",
            "telephone_number": "402-750-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL SULLIVAN COUNSELING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-750-7923",
        "authorized_official_credential": "LCSW, CCGC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026181901",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Norfolk, NE
• Providers in Norfolk, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.