Danielle D Sullivan, LMFTA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2454 Issued in NC

Practice address

13500 NC Highway 50
Surf City, NC 28445-7934

Phone

(910) 319-8558

NPI assigned

Feb 23, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD (past)

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1851783286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 454",
            "city": "HOLLY RIDGE",
            "state": "NC",
            "postal_code": "284450454",
            "telephone_number": "910-319-8558",
            "fax_number": "833-799-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 NC HIGHWAY 50",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "284457934",
            "telephone_number": "910-319-8558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Progress Dr",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284253280",
            "country_code": "US",
            "telephone_number": "910-259-0668",
            "fax_number": "910-202-9966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DANIELLE",
        "middle_name": "D",
        "credential": "LMFTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "2454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Physical Therapy, LLC
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• Sandy Shores Primary Care, PLLC
• Tina Marie Stanley, R.T.
• Still Waters Therapy PLLC
• Surf City Urgent Care and Family Medicine PLLC
• Phillip Carl Tart, O.D.
• Danielle Feck Theberge, WHNP
• Time 2 Learn Inc
• Trudy Mary Cook LCSW PC

• Marriage & Family Therapist in Surf City, NC
• Providers in Surf City, NC by specialty
• Marriage & Family Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.