Rebecca L Sullivan, MS, NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2994 Issued in CT

Practice address

66 N Main St
Branford, CT 06405-3032

Phone

(203) 645-5563

NPI assigned

Mar 14, 2016

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

Other names 1

• Rebecca LM Sullivan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1922469212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 N MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053032",
            "telephone_number": "203-645-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 N MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053032",
            "telephone_number": "203-645-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "MS, NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "SULLIVAN",
            "middle_name": "LM",
            "credential": "MS, NCC, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Professional Counselor in Branford, CT
• Providers in Branford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.