Brandi Sullivan, COTA

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

32003246A Issued in IN

Practice address

2626 Saint Joe Center Rd
Fort Wayne, IN 46825-5042

Phone

(260) 497-0328

NPI assigned

Dec 8, 2017

Sex

Female

Sole proprietor

No

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)

Not 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 and National Provider Directory roles.

• Hand in Hand Comprehensive Therapy Specialists Inc

  • Occupational Therapist
  • Fort Wayne, IN
  • NPI 1942465679
  NPD
• Hand in Hand Therapy

  • Early Intervention Provider Agency
  • Fort Wayne, IN
  • NPI 1912551524
  NPD (past)

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1891200192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9426 LIMA RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468188680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 SAINT JOE CENTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255042",
            "telephone_number": "260-497-0328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9426 Lima Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "46818",
            "country_code": "US",
            "telephone_number": "260-497-0328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "BRANDI",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "32003246A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Nirmal Prasan Sudharsana Doss, PT
• Margaret Elyse Sulfridge, BCBA, COBA
• Sullivan Counseling
• Sullivan Counseling Group LLC
• Sullivan Services, Inc.
• Dian Sullivan, LCSW
• Kate Sullivan
• Laverne A Sullivan, RD
• Maralissa A Sullivan, MS
• Nicholas Joseph Sullivan, D.C.

• Occupational Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.