Martin Sullivan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00315100 Issued in NJ

Practice address

41 Reckless PL
Red Bank, NJ 07701-1703

Phone

(732) 996-9072

Fax

(732) 530-4534

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

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.

• Client-Focused Family Counseling

  • Community/Behavioral Health Agency
  • Fair Haven, NJ
  • NPI 1376851717
  NPD (past) Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861605156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 BUENA VISTA AVE",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043526",
            "telephone_number": "732-996-9072",
            "fax_number": "732-530-4534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 RECKLESS PL",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011703",
            "telephone_number": "732-996-9072",
            "fax_number": "732-530-4534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00315100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0043532",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lou Storey, LCSW, LCADC
• Christina Marie Stratton, MS, LAC, NCC
• Strength in Sharing
• Johanna Strobel, PSYD
• Matthew G Strobel, PSY.D.
• Stephanie Sullivan, MS, LAC, NCC
• Support Connection LLC
• Supreme Medical Solutions
• Suzanne Quigley DMD, LLC
• Elizabeth Sweet-O'Brien, LCSW

• Professional Counselor in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.