Active NPI
Christine Sullivan, LMSW
- Professional Counselor
- Wantagh, NY
National Provider Identifier
1720487739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 089201-1
- Practice address
- 2138 Wantagh Ave
Wantagh, NY 11793-3941 - Phone
- (516) 317-1683
- NPI assigned
- Aug 14, 2014
- Last updated
- Jan 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 089201-1 | NY | Primary |
Addresses
Primary practice location
2138 Wantagh Ave
Wantagh, NY 11793-3941
Mailing address
2138 Wantagh Ave
Wantagh, NY 11793-3941
Phone (516) 317-1683
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
| License | State | Type | Specialty |
|---|---|---|---|
| 089201-1 | NY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1720487739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2138 WANTAGH AVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117933941",
"telephone_number": "516-317-1683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2138 WANTAGH AVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117933941",
"telephone_number": "516-317-1683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CHRISTINE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-14",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NY",
"license": "089201-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wantagh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.