Angela Diahann Sullivan, PMHNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN.CNP.0039823 Issued in OH

Practice address

4998 W Broad St Ste 104
Columbus, OH 43228-1647

Phone

(419) 917-6466

NPI assigned

Aug 9, 2022

Last updated

Jan 3, 2026By the provider in NPPES

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 OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Woodstream Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Miamisburg, OH
  • NPI 1265001234
  Medicare reassignment NPD
• Owlbridge Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Middletown, OH
  • NPI 1518587997
  NPD
• WS Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Miamisburg, OH
  • NPI 1225710668
  NPD

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767398400000",
    "number": "1871221788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4998 W BROAD ST STE 104",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281647",
            "telephone_number": "419-917-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4998 W BROAD ST STE 104",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281647",
            "telephone_number": "419-917-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANGELA",
        "middle_name": "DIAHANN",
        "credential": "PMHNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2026-01-03",
        "certification_date": "2026-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0039823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Ann Sulitis, CRNA
• Christine Marie Sulka, CCC/SLP
• Jean Sullenberger, LPCC
• Joseph Lend Sullens Jr.
• Sullivan Plastic and Reconstructive Surgey Center, Inc
• Anne C Sullivan, M.D.
• Christine M Sullivan, M.D.
• Damonte Sullivan
• Dandre Sullivan
• Daniel Sullivan, PHD

• Psychiatric/Mental Health Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.