Anthony M Sullivan Psychological Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

ANTHONY M SULLIVAN PSYCHOLOGICAL SERVICES LLC

Practice address

608 S 9TH St
Canon City, CO 81212-4910

Phone

(719) 275-5185

NPI assigned

May 25, 2023

Organization subpart

No

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

Authorized official

Name

Anthony Sullivan, PSYDNPI 1245362615

Title

Owner

Phone

(719) 275-5185

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony Michael Sullivan, PSYD

  • Clinical Psychologist
  • Canon City, CO
  • NPI 1245362615
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1770275869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124910",
            "telephone_number": "719-275-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124910",
            "telephone_number": "719-275-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY M SULLIVAN PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-275-5185",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W. Anderson
• Julie L Anderson, LPC
• Mark Andreis
• Stacy Andrews, MA, LPC
• Timothy Arthur Andrews, OTR, CHT
• Sherry Archibeque
• Argus Home Care Inc (Argus Home Care Canon City)
• Arkansas Valley Surgery Center
• M. Jean Armour, LPC, BSN, CACIII
• Derek Wayne Ashby, OD

• Clinical Psychologist in Canon City, CO
• Providers in Canon City, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.