Active NPI
Mollie Elizabeth Sullivan, SLP
- Speech-Language Pathologist
- Muncy, PA
National Provider Identifier
1750909602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- PSL001311
- Practice address
- 215 E Water St
Muncy, PA 17756-8828 - Phone
- (570) 321-2680
- NPI assigned
- Jul 8, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | PSL001311 | PA | Primary |
Addresses
Primary practice location
215 E Water St
Muncy, PA 17756-8828
Mailing address
215 E Water St
Muncy, PA 17756-8828
Phone (570) 321-2680
Other practice location 1
700 High St
Williamsport, PA 17701-3100
Phone (570) 321-2680
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 |
|---|---|---|---|
| PSL001311 | PA | MD | Speech-Language Pathologist |
Interoperability endpoints
- mollie.e.sullivan@upmcdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594166400000",
"number": "1750909602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 E WATER ST",
"city": "MUNCY",
"state": "PA",
"postal_code": "177568828",
"telephone_number": "570-321-2680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 E WATER ST",
"city": "MUNCY",
"state": "PA",
"postal_code": "177568828",
"telephone_number": "570-321-2680"
}
],
"practiceLocations": [
{
"address_1": "700 High St",
"address_purpose": "LOCATION",
"city": "Williamsport",
"state": "PA",
"postal_code": "177013100",
"country_code": "US",
"telephone_number": "570-321-2680",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "MOLLIE",
"middle_name": "ELIZABETH",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-08",
"last_updated": "2020-07-08",
"certification_date": "2020-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "PSL001311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Muncy, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.