Individual provider Active NPI

Sean Anthony O'Sullivan, LCPC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1689158362
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
160.006207 Issued in IL
Practice address
2310 W Roosevelt Rd
Chicago, IL 60608-1131
Phone
(312) 655-7984
NPI assigned
Sep 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 160.006207 IL Primary

Addresses

Primary practice location

2310 W Roosevelt Rd
Chicago, IL 60608-1131

Mailing address

357 W Dickens Ave
Chicago, IL 60614-4645
Phone (773) 940-9512

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

LicenseStateTypeSpecialty
160.006207ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1689158362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 W DICKENS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144645",
            "telephone_number": "773-940-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081131",
            "telephone_number": "312-655-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "SEAN",
        "middle_name": "ANTHONY",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "160.006207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.