Alicia Lynn Sullivan, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

06003 Issued in MD

Practice address

707 N Broadway
Baltimore, MD 21205-1832

Phone

(443) 923-1872

NPI assigned

May 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Kennedy Krieger Associates

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1871515783
  Medicare reassignment NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Middle River, MD
  • NPI 1841009842
  NPD

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1750760393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 E BIDDLE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212133939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "443-923-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ALICIA",
        "middle_name": "LYNN",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "06003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Belal Suliman
• Lauren R Suling
• Mark Sulkowski, M.D.
• Paige Morgan Sullivan-Hvizdos, CF-SLP
• Catherine Mary Sullivan-Windt, PH.D.
• Alison L Sullivan, LCSW-C
• Amanda Sullivan, OTR
• Benjamin Alexander Sullivan, P.A.-C
• Brooke Alexandria Sullivan
• Cari Rose Sullivan, PT

• Psychologist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.