Active NPI
Veronica N Sullivan, PH.D.
- Clinical Psychologist
- Vancouver, WA
National Provider Identifier
1639459191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60540411
- Practice address
- 12607 SE Mill Plain Blvd
Vancouver, WA 98684-4098 - Phone
- (518) 894-8263
- NPI assigned
- Aug 27, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | TPPY3078 | FL | |
| Clinical Psychologist | 103TC0700X | PY60540411 | WA | Primary |
Addresses
Primary practice location
12607 SE Mill Plain Blvd
Vancouver, WA 98684-4098
Mailing address
12607 SE Mill Plain Blvd
Vancouver, WA 98684-4098
Phone (518) 894-8263
Other practice location 1
390 NE 191st St Ste 8333
Miami, FL 33179-3899
Phone (561) 730-2457
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2026 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TPPY3078 | FL | MD | Clinical Psychologist |
| PY60540411 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lbee Health Practice Group PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Miami, FL
- NPI 1548014905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764028800000",
"number": "1639459191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12607 SE MILL PLAIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986844098",
"telephone_number": "518-894-8263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12607 SE MILL PLAIN BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986844098",
"telephone_number": "518-894-8263"
}
],
"practiceLocations": [
{
"address_1": "390 NE 191st St Ste 8333",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331793899",
"country_code": "US",
"telephone_number": "561-730-2457",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "VERONICA",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-27",
"last_updated": "2025-11-25",
"certification_date": "2025-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "TPPY3078",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60540411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.