Erin Kathleen Sullivan Baker, RN M COUN,LPC MS PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-994 Issued in ID

Practice address

210 W Burnside Ave Ste a
Chubbuck, ID 83202-4916

Phone

(208) 233-2051

NPI assigned

Jan 14, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Erin Kathleen Sullivan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mental Health Specialists

  • Clinical Social Worker
  • Chubbuck, ID
  • NPI 1548585458
  NPD (past)

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1780158634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE STE A",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024916",
            "telephone_number": "208-233-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE STE A",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024916",
            "telephone_number": "208-233-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN BAKER",
        "first_name": "ERIN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "RN M COUN,LPC MS PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "SULLIVAN",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.