Sherry Denise Sullens, MA, LPC, CADCII

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

182 SW Academy St
Dallas, OR 97338-1996

Phone

(503) 831-5970

NPI assigned

Dec 6, 2006

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

Medicare fee-for-service enrollment

Enrolled in OR

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

Master of Arts

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.

• Salem Psychiatric Associates, P.C.

  • Psychiatry Physician
  • Salem, OR
  • NPI 1619061314

  Professional

  Medicare reassignment NPD
• Salem Psychiatric Associates PC

  • Clinical Social Worker
  • Salem, OR
  • NPI 1912121526
  NPD

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1831258979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12505 AIRLIE RD",
            "city": "MONMOUTH",
            "state": "OR",
            "postal_code": "973619765",
            "telephone_number": "971-241-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 SW ACADEMY ST",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381996",
            "telephone_number": "503-831-5970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "182 SW Academy St",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "OR",
            "postal_code": "973381996",
            "country_code": "US",
            "telephone_number": "503-831-5970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12505 Airlie Rd",
            "address_purpose": "LOCATION",
            "city": "Monmouth",
            "state": "OR",
            "postal_code": "973619765",
            "country_code": "US",
            "telephone_number": "971-241-8680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 NW 4th St",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973304702",
            "country_code": "US",
            "telephone_number": "971-241-8680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLENS",
        "first_name": "SHERRY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC, CADCII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hannah Joy Swan
• Katherine Elizabeth Tate
• Eric Taylor, SLP
• Llama Taylor, L.C.S.W.
• Pilar Taylor

• Professional Counselor in Dallas, OR
• Providers in Dallas, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.