Individual provider Active NPI

Adam Sullivan

  • Mental Health Counselor
  • Bellevue, WA
National Provider Identifier
1851867436
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61237736 Issued in WA
Practice address
9 Lake Bellevue Dr Ste 217
Bellevue, WA 98005-2454
Phone
(206) 486-5642
NPI assigned
Oct 22, 2018
Last updated
Jul 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH61237736 WA Primary

Addresses

Primary practice location

9 Lake Bellevue Dr Ste 217
Bellevue, WA 98005-2454

Mailing address

240 S Sunnyside Ave Unit 187
Sequim, WA 98382-4007
Phone (206) 486-5642

Other practice location 1

435 W Bell St Ste B
Sequim, WA 98382-2916
Phone (206) 486-5642

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

State licenses

LicenseStateTypeSpecialty
LH61237736WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Adam Sullivan LLC Mental Health CurrentSince Oct 16, 2022 Accepting new patients
Sequim Counseling LLC Mental Health Past Accepting new patients

Locations

9 Lake Bellevue Dr
Ste 217
Bellevue, WA 98005
Phone (206) 375-9236

430 E Lauridsen Blvd
Ste 212
Port Angeles, WA 98362
Phone (360) 457-5139

240 S Sunnyside Ave
Unit 187
Sequim, WA 98382

240 S Sunnyside Ave
Unit 2753
Sequim, WA 98382

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1851867436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S SUNNYSIDE AVE UNIT 187",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983824007",
            "telephone_number": "206-486-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 LAKE BELLEVUE DR STE 217",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052454",
            "telephone_number": "206-486-5642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 W Bell St Ste B",
            "address_purpose": "LOCATION",
            "city": "Sequim",
            "state": "WA",
            "postal_code": "983822916",
            "country_code": "US",
            "telephone_number": "206-486-5642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61237736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.

Verify at the official NPI Registry.