Doreen Sullivan Davis, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-141813

Practice address

20 Spruce LN
Glastonbury, CT 06033-1668

Phone

(860) 798-4239

NPI assigned

Sep 11, 2018

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

Other names 1

• Ms. Doreen Ann Sullivan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1659854032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SPRUCE LN",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331668",
            "telephone_number": "860-798-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SPRUCE LN",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331668",
            "telephone_number": "860-798-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DOREEN",
        "middle_name": "SULLIVAN",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "L-141813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOREEN",
            "last_name": "SULLIVAN",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Michelle Danieluk, BCBA-LBA
• John M Dasilva, M.D.
• Peter Dasilva, MS OTR/L
• Alison David
• Carlene Davidson, PSY.D.
• Mary Davis, LCSW, RD
• Gary William Dayton, PSY.D.
• Anna-Christina Decker, OTR/L
• Alexandra Defrance, PA-C
• Joseph P Defrancesco, DC

• Lactation Consultant (Non-RN) in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Lactation Consultant (Non-RN) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.