Individual provider Active NPI

Renee Sullivan, M.A., L.P.C.

  • Professional Counselor
  • Gillette, WY
National Provider Identifier
1831602317
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1686 Issued in WY
Practice address
1401 W 2ND St Unit 1
Gillette, WY 82716-3334
Phone
(307) 682-6699
NPI assigned
Nov 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0022007 CO
Professional Counselor 101YP2500X MBTCOU-10141 ID
Professional Counselor 101YP2500X 1686 WY Primary

Addresses

Primary practice location

1401 W 2ND St Unit 1
Gillette, WY 82716-3334

Mailing address

1311 E Omaha Ave
Fresno, CA 93720-2250
Phone (307) 680-0859

Other practice location 1

1311 E Omaha Ave
Fresno, CA 93720-2250
Phone (307) 680-0859

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0022007COMDProfessional Counselor
MBTCOU-10141IDMDProfessional Counselor
1686WYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Preuit & Daigle Professional Counseling P.C. Professional Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1831602317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 E OMAHA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202250",
            "telephone_number": "307-680-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W 2ND ST UNIT 1",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163334",
            "telephone_number": "307-682-6699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1311 E Omaha Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202250",
            "country_code": "US",
            "telephone_number": "307-680-0859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "RENEE",
        "credential": "M.A., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0022007",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "MBTCOU-10141",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "1686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.