Individual provider Active NPI

Olivia Sullivan

  • Professional Counselor
  • Pittsburg, KS
National Provider Identifier
1710692678
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
04351 Issued in KS
Practice address
3011 N Michigan St
Pittsburg, KS 66762-2546
Phone
(620) 231-9873
Fax
(620) 231-5062
NPI assigned
Jan 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 03215 KS
Professional Counselor 101YP2500X 04351 KS Primary

Addresses

Primary practice location

3011 N Michigan St
Pittsburg, KS 66762-2546

Mailing address

PO Box 1832
Pittsburg, KS 66762-1832
Phone (620) 240-5668

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240313002534 KS Practitioner - Mental Health Counselor 8628414554 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Southeast Kansas Inc CurrentSince Feb 6, 2024 Accepting new patients
Community Health Center of Southeast Kansas Inc CurrentSince Feb 6, 2024 Accepting new patients

Locations

1017 E Market St
Lacygne, KS 66040
Phone (913) 757-4575

3011 N Michigan St
Pittsburg, KS 66762
Phone (620) 231-1960

1011 S Mount Carmel Pl
Pittsburg, KS 66762
Phone (620) 231-6160

Interoperability endpoints

  • Direct secure messaging: olivia.sullivan@chcsek.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1710692678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1832",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667621832",
            "telephone_number": "620-240-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 N MICHIGAN ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622546",
            "telephone_number": "620-231-9873",
            "fax_number": "620-231-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-16",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KS",
            "license": "03215",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "04351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

Verify at the official NPI Registry.