Active NPI
Sydney Sullivan, BCBA
- Behavior Analyst
- East Brookfield, MA
National Provider Identifier
1821562455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-44781
- Practice address
- 103 Mechanic St
East Brookfield, MA 01515-9800 - Phone
- (413) 459-9565
- NPI assigned
- Jan 16, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Behavior Analyst | 103K00000X | 1-20-44781 | MA | Primary |
Addresses
Primary practice location
103 Mechanic St
East Brookfield, MA 01515-9800
Mailing address
103 Mechanic St
East Brookfield, MA 01515-9800
Phone (413) 459-9565
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688860800000",
"number": "1821562455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 MECHANIC ST",
"city": "EAST BROOKFIELD",
"state": "MA",
"postal_code": "015159800",
"telephone_number": "413-459-9565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 MECHANIC ST",
"city": "EAST BROOKFIELD",
"state": "MA",
"postal_code": "015159800",
"telephone_number": "413-459-9565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "SYDNEY",
"name_prefix": "Miss",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2023-07-09",
"certification_date": "2023-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "1-20-44781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Brookfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.